APGO

Background: OBGYN trainees are at risk of burnout. Narrative medicine (NM) employs reflection to explore complex phenomena, which offers a promising tool to nurture connections with patients and process emotional stress.

Methods: Residents at three academic hospitals participated in a yearlong NM curriculum of eight, one-hour reflective writing sessions on relevant themes (e.g. work/life balance, pregnancy loss). Residents completed an online pretest and posttest after 1 year that included demographics, the Maslach Burnout Inventory (which assesses burnout on three subscales: emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA)), and a modified Interpersonal Reactivity Index (IRI). Mean change in pretest/posttest scores was compared using t-tests. Cohen’s d was used to calculate effect size. 

Results: Seventy residents participated. Complete pretest/posttest pairs were available for 42 residents. NM attendance ranged from 0-8 sessions, median/mean 4 sessions. Twenty-one residents attended fewer than four, and 21 four or more sessions. Pretest burnout was moderate/high for 40 residents in EE (95%), and 42 residents in DP (100%). Eighteen (42%) had preserved PA. Burnout profiles worsened in all domains. Baseline burnout profiles were equal, but EE improved in residents in the high attendance group (p=0.04, d=0.62) at 1 year. IRI scores were stable.

Discussions: Emotional exhaustion and depersonalization are high among OBGYN residents, and burnout worsens over time. Residents do demonstrate preserved sense of personal accomplishment and robust empathy. Attendance at narrative medicine sessions improved emotional exhaustion in this cohort. 

Keywords: Narrative Medicine, Burnout