558 - Integration of wellness into the clerkship period: An innovative curriculum

Poster Number: 558
Publication Number: 558.115

Heidi M. Kloster, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States

Background: Medical student burnout, depression, and suicide are cause for significant concern and have prompted wellness curricula in medical schools across the country. Many of these efforts are focused on the preclinical period. The feasibility and efficacy of a wellness curriculum within a clinical clerkship has not been reported. We implemented an innovative wellness curriculum during the required medical student Ambulatory Care Clerkship. 

Objective: The objectives were to 1) determine students' stress and burnout pre- and post-exposure to the curriculum and 2) investigate the impact of the curriculum on participants' attitudes and behaviors regarding wellness practices.

Design/Methods: Curricular content focused on nutrition, physical activity, mindfulness, sleep, and the arts. It was designed to be experiential and based in the conceptual framework of situational learning-guided participation. All students took part in the curriculum for at least one hour weekly during the rotation. Didactics were required, but other experiences were voluntary, leading to variable exposure to the intervention based on students' level of interest. We developed pre- and post-exposure surveys that included demographic questions, the short (2-item) Maslach Burnout Inventory (MBI), and the 10-item Perceived Stress Scale. Additional questions examined student attitudes and behaviors regarding wellness practices using a 5-point Likert scale. Students completed the voluntary survey during the 2019-2020 academic year.

Results: Post-clerkship, students reported that involvement in wellness activity was inversely related to their stress/burnout levels (figure 1). However, we found no changes in attitudes towards practicing wellness or burnout levels as measured by MBI when comparing pre-clerkship responses (Nf141) with post-clerkship responses (Nf70). Conclusion(s): Overall, the curriculum was feasible, well-received, and may be replicated at other institutions. Students engaging in wellness practices during the clerkship period exhibit lower rates of burnout. However, our curriculum did not appear to impact overall student attitudes and behaviors regarding wellness, nor did it shift their perceived stress or burnout. For students already engaged in wellness practices, behaviors can be maintained during required clerkships via integration of curricula such as ours. Future work is essential to determine how medical schools may best support all students' well-being via formalized curricula and to further examine why certain students appear to be "protected" from burnout due to the ability to incorporate certain wellness practices.
Wellness Modality Exposure and Burnout RateBurnout as defined by 2-item MBI