Effect of Reflective Writing on Burnout in Medical Trainees

Abstract

This article was migrated. The article was not marked as recommended. Introduction: Narrative Perspective and Reflective Writing is a fourth-year elective at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell. This is the first study to show through both quantitative and qualitative data that medical students who participated in such a course experienced lower burnout. Preliminary data suggests that the course also fostered increased resilience. Methods: This longitudinal course was offered to all fourth-year medical students as an elective. Assessments were administered electronically to students before starting the course and following the final session. Pre- and post- course questionnaires consisted of items from the Maslach Burnout Inventory (MBI) for both cohorts. The Connor-Davidson Resilience Scale (CD-RISC) was added to the questionnaire for the second cohort only. Results: There were statistically significant reductions in emotional exhaustion and depersonalization from pre- to post-course assessments. There were modest, but not statistically significant, increases in the MBI subscale of personal accomplishment subscale and on the Connor-Davidson Resilience scale. Qualitative student feedback was overwhelmingly positive. Discussion: These findings suggest that engagement with health humanities can reduce burnout and possibly increase resilience in medical trainees. The course is well-aligned with efforts to incorporate communication and empathy training into postgraduate and continuing medical education. It is an enriching and effective intervention that can reduce burnout at a critical point in students' medical training. Limitations: Limitations of our study are discussed, as are strategies to control for confounding variables. The challenges faced in implementing more humanities-based courses into medical education are briefly presented. Conclusion: This is the first study to show both quantitatively and qualitatively that fourth-year medical students participating in a health humanities course experienced reduction in burnout. The positive impact of this humanities-based elective on medical trainees at a crucial juncture of their careers should prompt more widespread implementation of humanities-based electives in medical education.