Solution-Oriented Approach to Implementation of a Resident Wellness Series (Descriptive Abstract)

ACADEMIC PEDIATRICS making self-care and mindfulness practices more accessible, and encourage emotional well-being and listening. The themes explored include: narrative humility, delivering bad news, death and illness, and self-care. Workshops begin by asking residents, “What may be preventing you from being present for the hour?” along with brief meditation and breathing exercises. These moments enable participants to acknowledge barriers preventing them from being attentive, and allow reflection. Resident perspectives are elicited through discussions and post-workshop surveys to discover which, if any, elements of the curriculum support them emotionally. Examples of discussion topics include: How overwhelmed do you feel as a resident; how much value do you place on time throughout the day; how much time do you take for yourself, and how do you find solitude and well-being in these moments; do you feel supported; how do you deal with stress; what is the purpose of the workshop for you as a resident; how will these methods help to be present to patients, families, and residents themselves? Preliminary analysis of curriculum feedback reveals that NM workshops help with coping with stress, give time to relax and self reflect, and increase positive physician/patient engagement. Ongoing data collection will contribute to further analysis as workshops progress. Given the high stress, anxiety-provoking environment that is a fact of residency, a comprehensive wellness curriculum is known to strengthen resident well-being. Incorporating a NM component into a wellness curriculum could teach residents to listen and reflect, improve humane and effective communication, promote more meaningful patient interactions, and foster resilience among pediatric residents. 95. SOLUTION-ORIENTED APPROACH TO IMPLEMENTATION OF A RESIDENT WELLNESS SERIES (DESCRIPTIVE ABSTRACT) Hillary A. Franke, MD MS, Sean P. Elliott, MD, Hilary McClafferty, MD, University of Arizona, Tucson, AZ BACKGROUND: ACGME guidelines on physician wellbeing mandate residency programs to focus on wellness. Common challenges include identification of engaging topics, optimal venues, and program sustainability. A collaborative, goal-directed approach to wellness curriculum development with resident engagement can promote program sustainability. OBJECTIVE: Our primary objective was to develop a sustainable resident-supported wellness series that promotes personal growth for individual residents. METHODS: The UA pediatric residency program prioritized resident wellness based on year-end resident feedback. Wellness activities currently in place include topic talks, yearly retreats and participation in the Pediatric Integrative Medicine in Residency (PIMR) national pilot program, comprised of evidence-based teaching on mind-body therapies, nutrition, sleep, exercise and self-care. The goal was to develop a more formalized Resident Wellness Series to build on to the current curriculum. A focus group of interested faculty and residents outlined the aims of the Resident Wellness Series. Evaluation is underway and ongoing. RESULTS: The focus group determined that the wellness series be a protected time to relieve resident’s stress and allow exploration of new approaches to wellness. A half-hour time period during teaching day was carved out monthly. All sessions are organized by residents or have resident support. Topic examples are enhanced coping skills, chair yoga, meditation, and gratitude journaling. Session leaders are content experts, either UA faculty

ABSTRACTS

e41

or community practitioners. Evaluations show that residents look forward to the sessions and like a schedule of stress management activities with one activity requiring movement (yoga) alternating with one centering on contemplation (meditation). CONCLUSIONS: The residents have embraced the Resident Wellness Series. A focus on stated goals and active involvement of residents in curriculum development and planning of sessions has been integral to its success. A goal-driven, solution-oriented approach to a Resident Wellness Series can be successful and sustainable.

** Winner - APPD 2017 Research Award ** 96. BURNOUT STATUS AND MILESTONE PERFORMANCE IN PEDIATRIC RESIDENTS (RESEARCH ABSTRACT) Betty B. Staples, MD, Duke University Hospital, Durham, NC, Janet R. Serwint, MD, Johns Hopkins University, Baltimore, MD, Maneesh Batra, MD MPH, University of Washington, Seattle, WA, Alan Schwartz, PhD, University of Illinois College of Medicine at Chicago, Chicago, IL, Paria M. Wilson, MD, MEd, Cincinnati Children’s Hospital Medical Center/University of Cincinnati College of Medicine, Charles Schubert, MD, Cincinnati Children’s Hospital Medical Center/University of Cincinnati College of Medicine, Cincinnati, OH, Hilary McClafferty, MD, University of Arizona, Tucson, AZ, John D. Mahan, MD, Nationwide Children’s Hospital/Ohio State University, Columbus, OH, Kathi J. Kemper, MD, MPH, Nationwide Children’s Hospital/ Ohio State University, Blacklick, OH, Pediatric Residency Burnout and Resilience Consortium, Durham, NC BACKGROUND: Burnout in trainees has gained attention because of its potential relationship to depression and negative impact on patients. Milestones have been utilized to measure the competency of residents in training. OBJECTIVE: To compare the mean Milestone scores between pediatric residents who met criteria for burnout and those who did not by level of training. METHODS: This work was completed as part of the Pediatric Residency Burnout and Resilience Consortium (PRBRC), a consortium of 34 programs, with the support of APPD LEARN. PRBRC conducted a confidential online survey of its members’ residents in April to June, 2016, which included the Maslach Burnout Inventory (MBI). In addition, programs submitted their assessment of residents’’ milestones. Burnout was defined as high range for either emotional exhaustion or depersonalization domains of the MBI. We examined the relationship between burnout and performance as assessed by milestones by domain of competence and stratified by post-graduate year. RESULTS: 1494 residents at 31 programs completed the MBI and had milestone data submitted. While residents who met criteria for burnout scored lower on all 21 Milestones compared with those without burnout, when PGY2 and PGY3 residents were examined the association between burnout status and milestone performance was not statistically significant. However, in the PGY1 cohort, those who screened positive for burnout had lower milestones in the following domains: patient care (2.97 vs 2.76, -0.21, p¼0.001), systems based practice (2.86 vs 2.68, -0.18, p¼.004), problem based learning and improvement (2.93 vs. 2.74, -0.19, p¼0.002), professionalism (3.24 vs. 3.07, -0.17,