Background: Self-reflection is an essential tool to foster professional and personal development during medical training. The inpatient setting presents specific challenges to developing physicians, as housestaff grapple to negotiate death and dying, difficult patient interactions, and building therapeutic alliances within limited time. It’s not surprising that burnout and compassion fatigue increase during training. Integrating reflective practices is a novel way to inspire residents to develop self-care and grow into leaders who are capable of building relationships founded on compassion and respect for the needs of others. While professionalism, interpersonal and communication skills, and systems-based practice are ACGME competencies on which we evaluate residents, there are few established ways to teach these skills. Investigating our clinical experiences through collective reflection can help foster these competencies and also encourage physicians to find meaning and joy in their practice.
Purpose: Our aim was to innovate a structured and reproducible course that fosters professional development by giving residents tools necessary to reflect on and meaningfully learn from their clinical experiences.
Description: We developed a curricular model called “Reflection Rounds,” which is part of an integrated Wellness Curriculum. The course is conducted during protected time. Sessions are presented as a safe space to explore ideas and interrogate emotions and ethical dilemmas that arise during clinical training. Discussions have included, “Grappling with Loss,” “Negotiating Cultural Differences,” and “Joy in Practice.” Conversations are structured around selected readings — prose, poetry, or journalism and time for written reflection in response to specific prompts. Participants then share their writing or reflections on the process of producing their
personal narratives.
We administered a survey to interns before their first “Reflection Rounds” session. 14 of 28 interns surveyed rated their ability to reflect on their work as “insufficient.” 10 interns reported they seldom consider empathy in patient interactions. 85% feel that “Reflection Rounds” could positively impact their rapport with patients.
Conclusions: Reflective writing naturally lends itself to the skills attendant with clinical empathy and self-awareness. Residents are welcoming the opportunity to cultivate the fundamentally human aspects of themselves that otherwise can be neglected during training. The methods and skills taught in “Reflection Rounds” can be integrated during daily ward rounds as a method to debrief about patient deaths or challenging interactions. “Reflection Rounds” is a tool to foster skills defined within the ACGME core competencies of professionalism, interpersonal communication skills, and systems based practices. To this end, it stands to be a model to inspire physician leaders who will create meaningful and empathic therapeutic relationships with patients and colleagues.