Reflection rounds to facilitate resilience in hematology/medical oncology fellows.

Abstract

11019 Background: Given the prevalence of burnout among medical oncologists (40-60% in the literature), education on burnout risk factors, recovery, and prevention are needed urgently in training curricula for medical oncology fellows. Care of patients with cancer is increasingly complex, and often can seem overwhelming to new trainees. Debriefing as a resiliency skill to develop self-reflection and identify coping strategies may provide a durable way to navigate these complexities. Optimization of fellowship Reflection Rounds (RR) was selected as a fellow-led quality improvement (QI) project for the current academic year. Methods: A QI team including the APD and representatives from all levels of fellowship training was assembled. Feedback regarding previously unstructured, monthly, hour long faculty-facilitated RR for first year fellows was reviewed. Topics with associated readings were selected and paired with fellow-nominated faculty based on the most common recurring themes. The QI team administered the Stanford Professional Fulfillment Index (PFI) to all fellows at the midway point of the academic year. RR were re-structured to include a chaplain with trainee communication expertise and a chief fellow to participate the sessions to assess changes in trainee engagement. Repeat assessment of the Stanford PFI is planned for the end of the academic year. Results: Topics identified for discussion included handling bias, futile care, patient communication, end of life care, and work-life balance. 26 fellows completed the Stanford PFI including nine 1st year fellows, 13 2nd year fellows, and 6 3rd year fellows. Survey results revealed emotional and/or physical fatigue as areas of greatest need for improvement in fellow well-being with 27% of fellows reporting “moderate” emotional or physical exhaustion. Conclusions: RR provides a safe and effective forum to develop peer debriefing and self-refection as resiliency skills within hematology/medical oncology fellowship training. Optimization of RR will continue as fellows become more involved in planning and implementation of curricular improvements to promote resiliency and enhance wellness.