Fostering Humanism and Professionalism in Pediatric Residency Training

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Fostering Humanism and Professionalismin
Pediatric Residency Training
Boston Combined Residency in Pediatrics Boston
Medical Center Childrens Hospital Boston
Kate Garvey, M.D. Jennifer Kesselheim, M.D. .
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Is there moral erosion in residency?

• The demands of residency training discourage
  humanism
• Time constraints, sleep deprivation and patient
  volume can suppress compassion and empathy
• Residents experience high levels of burnout and
  depression, often unrecognized

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Intern Fears June 2007
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Intern Fears
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Intern Fears
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On to Junior Year
Scutmonkey Dr. Id in the Pediatric ER,
Michelle Au, M.D. http//theunderweardrawer.homes
tead.com/scutmonkey.html
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Humanism in Medicine
Arnold P. Gold Foundation I.E., C.A.R.E.S.
Integrity Excellence Compassion
Altruism Respect Empathy Service
www.humanism-in-medicine.org
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Professionalism

• American Board of Pediatrics
• Honesty/integrity
• Reliability/responsibility
• Respect for others
• Compassion/empathy
• Self-improvement
• Self-awareness/knowledge of limits
• Communication/collaboration
• Altruism/advocacy

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How can we train compassionate pediatricians?
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BCRP Humanism Curriculum
Other Lives PICU Family Voices Project
BCRP Humanism Discussion Curriculum
Communication Skills
Shared Experience
Support
Resident Reflection
Resident Reflection
Practical Review of Clinical Challenges
Humanism
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Discussion Curriculum Goals

• Basic Recipe
• Protected time and safe venue for residents to
  vent and share experiences
• Faculty role models
• Case vignettes as reflective triggers
• Exposure to narrative medical literature
• Empathy and reframing
• Perspective on patient/parent experience
• Depression and burnout awareness

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BCRP Humanism Discussion Curriculum

• Case-based, small group sessions
• 2-3 faculty facilitators and 10 residents per
  group
• Parallel curricula for interns and juniors
• Readings from narrative literature

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Discussion/Barriers

• Buy-in
• Logistics
• Coverage/rotation support
• Travel in the intern year
• Continuity in the junior year

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New Directions

• Experiments with novel session formats
• Intern orientation module
• Senior resident module in career development
  block
• Fellowship training in professionalism