731 - Reflecting Together: Narrative Medicine and Pediatric Resident Self-Reflection

Publication Number: 3707.731

Leah N. Ramkelawan, Stony Brook Children's Hospital, Centereach, NY, United States; Susan D. Walker, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States; Clare Whitney, Stony Brook University, Brooklyn, NY, United States; Shaun Besch, Renaissance School of Medicine at Stony Brook University, New York, NY, United States

Background: Narrative medicine is a technique of close reading and responsive writing which encourages self-reflection (Charon, 2001), a skill that involves actively recalling past experiences and applying knowledge, skills, and insight to understanding complex situations. Self-reflection is an important skill for physicians to develop as it fosters critical thinking and closer relationships between coworkers, patients, and families which, in turn, leads to better healthcare outcomes (Liao et al, 2019).

Objective: Narrative medicine workshops have been proven to improve wellbeing of participants, including pediatric residents, but little is known about their impact on self-reflection ability. In our study, we assessed the baseline level of self-reflection among our residents and implemented a 4-session narrative medicine experience to assess its impact on participant self-reflection ability.

Design/Methods: A short form of the validated Self-Reflection and Insight Scale was shown to have strong dimensionality, reliability, item fit, and local independence (Silvia 2020). Baseline self-reflection skills among residents were assessed using this validated tool. Subsequently, residents participated in one to four one-hour narrative medicine sessions. The sessions involved group reading and discussion of a piece of literature followed by reflective writing to a provided writing prompt. After four sessions were completed, residents repeated the validated self-reflection and insight scale along with long response questions. Data was analyzed using a paired samples T test.

Results: Initial pre-workshop data indicates a statistically significant effect of PGY year on reflection score. PGY2 residents showed significantly higher reflective scores than PGY1 or PGY 3 residents. Post workshop quantitative analysis did not reveal a statistically significant difference in the level of self-reflection before and after the workshops. Qualitative comments on the workshops indicated a high level of participant satisfaction.

Conclusion(s): Self-reflection skills of pediatric residents at our institution are high at baseline and vary by year. Narrative medicine workshops allow pediatric residents to practice reflecting on their experiences in a productive manner and in a way that yields normalization of each other's struggles. Feedback was overwhelmingly positive, indicating that narrative medicine fills a need among our residents.

Level of Self-Reflection Pre-survey vs. Post-survey
Quantitative analysis did not reveal a statistically significant difference in the level of self reflection before and after the workshops.

Reflection Composite Score vs. Post Graduate Year
Although PGY-2 shows slightly higher average reflection scores, the differences among PGY groups are not statistically significant (p > 0.05).

Qualitative Comments
Qualitative comments on the workshops indicated a high level of participant satisfaction.