Wellness, Resilience, and Burnout Among Pediatric Rheumatology Fellows: A Narrative Medicine Pilot Intervention

Background/Objectives: Recognizing workforce shortages and adverse impacts of trainee emotional exhaustion, we aimed to measure baseline levels of wellness, resilience, and burnout among pediatric rheumatology fellows as well as to understand the feasibility of implementing a narrative medicine intervention in this population. Methods: This study involved pre- and post-participation questionnaires for pediatric rheumatology fellows in the United States and Canada who participated in a narrative medicine intervention. Survey components included the Mini Z Burnout Survey, the Mayo Well-being Index and the Connor-Davidson Resilience Scale (CD-RISC), baseline demographics and self-reported burnout-related factors. Results: All sixteen invited fellows completed the pre-participation survey, and 15 of the 16 participants completed the narrative intervention. The median (range) baseline CD-RISC resilience score was 73.5 (44-88), and the baseline Mini-Z Burnout Survey showed high levels of burnout with a median (range) of 34 (17-44). The median (range) score of the baseline Mayo Well-being Index was 3 (0-7), with scores of ≥4 associated with physicians at risk of suicidal ideation and/or serious thoughts of leaving medicine. Following participation in the narrative medicine intervention, surveys showed a shift toward feelings that work is meaningful, as well as a shift toward feelings of having time for personal and family life. Conclusions: In this pilot study, baseline levels of wellness, resilience, and burnout among pediatric rheumatology fellows highlighted target areas to mitigate burnout and maximize resilience among fellows. Narrative medicine is a feasible and acceptable intervention, and future larger studies should investigate the possible impact of narrative medicine on burnout among pediatric rheumatology fellows.