563 - A Peer-Debriefing Educational Intervention for Pediatric Resident Physicians on a Pediatric Hematology/Oncology Rotation

Poster Number: 563
Publication Number: 563.116

Rachel S. Werk, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, United States; Brittany Cowfer, Vanderbilt University Medical Center, Nashville, TN, United States; Meng Xu, Vanderbilt University School of Medicine, Nashville, TN, United States; Jessica Turnbull, Vanderbilt University Medical Center, Nashville, TN, United States

Background: Health professionals are often exposed to upsetting patient care events, which can lead to emotional distress and burnout, potentially negatively impacting patient care. Debriefing can help providers process the complex emotions associated with these events. Resident physicians are often exposed to upsetting patient care events without participating in a debrief afterwards. Providing pediatric resident physicians with tools for facilitating debriefs will empower them to lead debriefs both during and after residency.

Objective: The goal of this project was to teach pediatric residents rotating on a Pediatric Hematology/Oncology rotation a standard debrief process and allow for them to practice leading a debriefing session.

Design/Methods: During a one hour session, using tools developed from the Children’s Hospital Los Angeles (CHLA) Peer-Debriefing Workshop, workshop leaders introduced the importance of debriefing and the peer-debriefing model. Participants role-played with hypothetical case scenarios utilizing the peer-debriefing model and also used the “Debriefing Pocket Card” as adapted and modified from the University of Michigan’s Peer Debriefing Workshop. Workshop leaders then conducted a debrief of the residents’ experiences during their clinical rotations utilizing the model. Pre- and post-session surveys (as adapted and modified from the CHLA Peer-Debriefing Workshop) assessed resident comfort and experience with participating and leading debriefs after upsetting patient care events.

Results: Thirty-two participants (72% PGY-2s) completed the pre-session survey and 21 of those completed the post-session survey. We performed paired t-test analyses on the pre- and post-session surveys to evaluate the efficacy of this educational intervention. Comfort level of leading a debrief increased a mean difference of 36 points from a baseline of 34.2 (SD of 17.3) on a 100 point scale (p < 0.001). Likelihood to lead a debrief increased 37.7 points (p < 0.001), feeling prepared to lead a debrief increased 38.3 points (p < 0.001), and the perception that formal debrief training is beneficial increased 11.8 points (p < 0.01). Free text responses indicated resident satisfaction with the intervention.Conclusion(s): By implementing an educational workshop on leading a debriefing session, we have empowered pediatric resident physicians to lead debriefs after upsetting patient care events. Future work will determine whether increased experience leading and participating in debriefs helps physicians in training emotionally process difficult events or enhances their well-being.