Effect of Reflective Writing on Burnout in Medical Trainees

Abstract

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 postcourse 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

Reflective Writing about Near-Peer Blogs: A Novel Method for Introducing the Medical Humanities in Premedical Education

“…Our analysis further revealed that study participants discussed both the positive and negative effects of medical students' empathic engagement with patients and their stories and included nuanced perspectives on the structural causes of burnout, including depersonalization and imposter syndrome. Self-reflective writing normalizes discussion of empathic conflicts, which has been shown to be critical for building resilience and combating burnout in health professionals (Chen and Forbes 2014;Narayan, Stern, and Fornari 2018;Harscher et al 2018;Pohontsch et al 2018). Our finding that premedical students were able to recognize burnout among their nearpeers, despite not experiencing burnout themselves, may have important educational implications in allowing them to better recognize and prevent burnout in themselves in the future (Jennings 2009).…”