Narrative medicine workshops for emergency medicine residents: Effects on empathy and burnout

Emergency medicine (EM) residents face unique affective challenges and barriers to interpersonal connection in their clinical environment which may contribute to decreased empathy and increased burnout. Narrative medicine (NM) might address these barriers and has had beneficial impacts in various populations but has never been studied in EM residents. In this study, we sought to evaluate the effect of NM workshops on burnout and empathy and to assess resident perceptions of the workshops.

We performed a quasi-experimental study at two EM residencies from June to October 2020. Residents at the intervention site participated in two NM workshops led by EM faculty that were composed of a close reading of a literary text, reflective writing, and group discussion. Residents were asked to complete the abbreviated Interpersonal Reactivity Index (IRI) and a single-item burnout measure pre- and postintervention. We fitted linear regression models to IRI subscores; we treated burnout as an ordinal variable and fitted a conditional logistic regression model. Residents completed a postintervention survey that we analyzed using summary statistics.

A total of 46.7% of control (28/60) and 100% of intervention (48/48) residents responded (n = 76). While all respondents demonstrated worsening burnout with time (p = 0.001), residents at the intervention site exhibited less severe increases (interaction p < 0.001). Empathy remained unchanged. A total of 50% of intervention residents (24/48) responded to the postintervention survey; most (n = 20, 83.3%) agreed that the workshops should be a standard part of EM didactics.

These findings establish the feasibility and desirability of NM in residency education and offers a model for EM-centered narrative workshops. Additionally, while our outcomes are limited, we found that exposure to an NM curriculum may be protective against worsening burnout.