Allegheny Health Network IM Residency - Wellness Discussion 2021

AHN IM Residency created wellness discussion groups for all their 110 residents. They meet during their ambulatory block with the chief resident. 

Results/Outcome Survey
1. What was the general understanding of the purpose of the project/program by participants?
The general understanding was that the residents were to be given time to decompress with each other after a very difficult year and share their experiences and stories about the positives and negatives that they experienced during COVID. The chief residents and some of the core faculty took groups of residents on 5 different days (Wednesday mornings running from 5/27-6/23), which were designated as a “wellness days” by the program in order to accommodate this activity.

Residents were asked to talk with their chiefs, each other and faculty about what they learned about themselves after going through the pandemic as a trainee. What were their struggles and how did they cope? What did they learn? In what ways did they grow? What did they learn about themselves, their colleagues, and their program? Was there anything they still are coping with?  After hearing some of the responses and how genuine and insightful they were at the first session, the chiefs asked the residents to write their experiences down and these were placed on leaves (green for areas of growth, and brown for things they want to “leave behind” or troubling experiences). Two of our residents are artists and painted a tree to place these leaves on which now hangs on the wall in our department of medicine to commemorate the difficult year and all that we gained and lost. The funds from POMA allowed for the residents to leave the hospital to go to a local coffee shop to get coffee for this experience. When the weather permitted, residents went to a local park to have their discussions and then were permitted to have a “field day” for the remainder of the morning. Faculty donated a “COVID piñata” which was also integrated into the wellness morning. This was one of the first social and live events of the year and was greatly appreciated by the residents.

2. During the project/program, what tangible tools or strategies were demonstrated or taught (i.e, coping skills for wellness and life balance)?
This project taught that the sharing of experiences can be therapeutic and that within this program, nobody is ever alone. Faculty and chiefs were able to share their vulnerable experiences with the residents and vice versa. This promoted a sense of community and support among the residents, which is one of the most important ways that wellness can be promoted in a training program.

3. What word(s) best describes how you feel when you are experiencing stress or well-being imbalance?
Isolation, Loneliness, Exhaustion, Fatigue, Uncertainty were some of the most frequent resident responses. 

4. What suggestions do you have to increase the probability of success for the project/program for other institutions?I would highly recommend implementing this project or a variation of the project at other institutions. I would recommend doing it at a place outside of the hospital if possible (outside is great). Allowing people to open up at their own pace is important. We learned that sending the response questions out in an email format prior to the activity allowed residents to think more about their answers so that they did not feel pressured or “put on the spot.” Training the chief residents prior with a book like crucial conversations may be helpful. 

5. What do you intend to do, upon returning to work, that you learned and practiced during the activity, that will improve your response to stressful situations?
Residents noted that they will be more apt to seek support from one another as well as their chief residents when they have an difficult situation at work. Others mentioned that they would be more comfortable sharing personal issues with their co-residents. It was also noted that social distancing played a role in the decreased willingness to share experiences, worries, and concerns as many residents did not see each other face to face as they were placed on remote learning electives during the peak of COVID. Should this be necessary in the future, we as a program need to do more to mitigate the isolation felt by our residents and more frequently check the “pulse” of the program’s morale.