Teaching Self-Care and Preventing Burnout During HPM Fellowship

Abstract

1.Describe a self-care “boot camp” didactic given during the first week of fellowship.2.Integrate a self-care learning-centered module into the HPM curriculum that keeps track of all fellowship requirements (including Accreditation Council for Graduate Medical Education, institutional, and program) and recommended content, in order to monitor self-care longitudinally.3.Discuss ways to prevent burnout during fellowship with practical curriculum-based examples. A hospice and palliative medicine (HPM) fellowship is usually 12 months of intensive learning and exposure to a high volume of patients with serious illness and those at the end of life. Fellows also learn to care for families during times of stress and high emotion. They learn that being a palliative care clinician requires a great deal of physical, emotional, and spiritual investment. Along with learning the basics of pain and symptom management, prognostication, and end-of-life care, equally important is learning professionalism, personal and professional boundaries, and self-care. Teaching self-care and encouraging self-reflection can be a challenge for faculty. This educational intervention describes how we approach teaching self-care in our HPM fellowship. After 3 years of our HPM fellowship, we discovered that teaching self-care and making it a top priority was essential for our trainees and faculty. We have also learned from experience how to teach and prevent burn-out for fellows using a structured approach. Two classes of fellows have completed the patient care and self-reflection module and given it positive feedback. Faculty have consistently given positive feedback for the structured self-care portion of the curriculum. The integrated curriculum created a heightened awareness and a more open dialogue about self-care among the HPM faculty, fellows, and staff. At the end of this academic year, we used faculty and fellow feedback to evaluate the success of the self-care module and curriculum in order to make changes and improve. We anticipate continued use of the patient care and self-reflection module as an integral part of the curriculum. Teaching and monitoring self-care in our fellowship will remain a high priority. Each class of fellows comes with a unique set of challenges to self-care. With feedback from fellows and faculty, we will continue to improve self-care as part of the HPM curriculum.