1. Meaningful Medicine: a modified curriculum to inspire meaning among resident physicians Marina MacNamara, MD, MPH Valerie Krall, LPA, LPC

2. Disclosures None.

3. Learning Objectives Consider the importance of training physicians in tools for the prevention of burn out and the promotion of well-being. Learn an innovative curriculum that applies positive psychology to the improvement of wellbeing among resident physicians. Share effective strategies in training physicians in the cultivation of well-being.

5. Significance of Physician Wellbeing Physician burnout can negatively impact patient care. Burnout prevalence among US physicians: 45.8% …among US residents: 17.6-76%

6. Models Individual –Personal stress reduction –Resilience/mindfulness training Group –Balint –Finding Meaning in Medicine (FMM) –Support groups

8. MAHEC Family Medicine Balint Finding Meaning in Medicine Peer support groups

9. Finding Meaning in Medicine Before: –PGY2-3 –Resident-facilitated –Sharing a reading Outcome: -Focus on daily stressors -Negative>positive

10. Capitalization

11. Evaluation 8/2015 (13/19=68%), 3/2016 (11/19=58%) 9 question survey, 5 qualitative –FMM –Burnout –Demographics Anonymous

12. Overall Themes Positivity, eg. when compared to support group Resident choice RE format Faculty participation

13. What do you ‘get’ from FMM sessions? I: The chance to reflect personally and through other’s experiences on the reasons we were drawn to FM in the first place. A reminder of the humanism of medicine. II: It’s a nice time of reflection to remember how I got myself into this crazy career.

14. I: I get to see a side of my co-residents that often we don’t talk about. We all tend to connect and I feel encouraged by what the other residents share – especially when on a rough patch. II: I feel supported by other’s with similar experiences and feel motivated to make changes personally.

15. Burnout Do you ever feel so emotionally exhausted that you feel negative about yourself and about your job and lose the feeling of concern for your patients? –YES, for 12/13 (92%), 10/11 (91%) Does the revised FMM group help address the burnout issue? –YES, for 11/13 (85%), 9/11 (82%)

16. Thoughts. Future Directions. The power of the group. Q1-2blocks (q4-8wks) Complementary, theme-focused FMM started by two interns, all faculty invited, Sunday evenings

17. References Diaz VA, Chessman A, Johnson AH, Brock CD, Gavin JK. Balint groups in family medicine residency programs: a follow-up study from 1990-2010. Fam Med. 2015 May;47(5):367-72. Fahrenkopf AM, Sectish TC, Barger LK, Sharek PJ, Lewin D, Chiang VW, Edwards S, Wiedermann BL, Landrigan CP. Rates of medication errors among depressed and burnt out residents: prospective cohort study. BMJ. 2008 Mar 1:336(7642):488-91. Gable SL, Reis HT, Impett EA, Asher ER. What do you do when things go right? The intrapersonal and interpersonal benefits of sharing positive events. J Pers Soc Psychol. 2004 Aug;87(2):228-45. Hershberger PJ. Prescribing Happiness: positive psychology and family medicine. Fam Med. 2005 Oct;37(9):630-4. Ludwig DS, Kabat-Zinn J. Mindfulness in medicine. JAMA. 2008 Sep 17;300(11):1350-2. Prins JT, Gazendam-Donofrio SM, Tubben BJ, van der Heijden FM, van de Wiel HB, Hoekstra- Weebers JE. Burnout in medical residents: a review. Med Educ. 2007 Aug;41(8):788-800. Seligman ME, Csikszentmihalyi M. Positive Psychology. An introduction. Am Psychol. 2000 Jan;55(1):5-14. Shanafelt TD, Boone S, Tan L, Dyrbye LN, Sotile W, Satele D, West CP, Sloan J, Oreskovich MR. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012 Oct 8;172(18):1377-85. Van Dyke A, Seger AM. Finding, keeping, and revitalizing the meaning in family medicine. Int J Psychiatry Med. 2013; 45(4):323-31.

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