Background: The prevalence of burnout is 45% in medical students and 35% in residents, while depression is similar at around 30%.1,2,3,4 In 2017, ACGME revised its common program requirements to emphasize “psychological, emotional, and physical well-being as critical in the development of the competent, caring, and resilient physician.”5 The 2022 CLER report found the “pandemic has adversely affected clinical care team well-being.”6 Much of the wellness literature has focused on engendering wellness through implementation of wellness curriculums, having “wellness champions,” scheduling events outside the hospital, easing work demands, increasing awareness, and building resilience and grit. Much less exists in the literature about how to implement wellness on a micro-level by leveraging the resource we have at our immediate and daily disposal, the hospital-based teams that we lead as faculty and in which many trainees arguably spend most of their time. The uniqueness of this intervention is it’s done daily inside the hospital as part of rounds.
Purpose: To promote trainee wellness on the wards through the use of art on daily rounds.
Description: Attending physician sits down with their inpatient team at the start of rounds everyday to discuss art for 10-15 minutes. The art can be digital or printed depending on setting. Following are examples that have been used:* The Castle is a mixed media sculpture by Jorge Mendes Blake. He constructed a brick wall that sits atop “The Castle,” a book by Franz Kafka. As you zoom out, you see how this seemingly inconsequently object has changed the entire facade of the wall. Once team members discuss what they see, the facilitator asks, “One single thing can change the entire facade of the wall, so what is the one thing each team member is going to work on this week?” It’s a great way to focus a trainee on a specific skill set rather than them feeling overwhelmed by all the things they need to work on.* A Twilight poster is used to discuss the concept of a “human minute.” For the uninitiated, Edward is a vampire and Bella is a human. This means Edward is much stronger and faster, and at some point, Bells says, “I need a human minute.” This art works very well on a call day when you know the team is going to be extremely busy. The facilitator asks the team what each member will do to take a “human minute” for themselves (i.e. a Starbucks break, hydrate, attend conference, etc). This allows trainees to reframe their day to incorporate wellness despite the chaos.* * Lucian Freud’s “Fat Sue,” a painting of a morbidly obese woman lying naked on a couch is shown side by side with the “Naked Maja” by Goya, a painting of a thin woman lying similarly on a couch. Trainees are asked to discuss differences, and the facilitator uses this to elicit “uncomfortable truths” in medicine. Prior discussions focused on chronic pain management, end of life conversations, discharging patients with poor support systems.
Conclusions: Medical training regardless of stage is very stressful, and wellness can feel like a mirage despite our best intentions. We need to recognize that wellness is multi-faceted, and includes promoting connectedness, self reflection/introspection, self-care, and resilience. Trainees consistently said that “Art of the Day” segment was an easy and accessible way to initiate open dialogue on all those fronts and bring wellness to the forefront despite the stress of their daily working environment.
