732 - Making Meaning in Medicine: Initial Findings Using the Facilitating Attuned Interactions Model in a Pediatric Residency Program

Publication Number: 3708.732

Laura Jane Miller, Emory University School of Medicine, Atlanta, GA, United States; D David OBanion, Emory + Children's Healthcare of Atlanta, Atlanta, GA, United States; Jessica Bartlett, Thriving Together, LLC, West Newton, MA, United States; Sarah Eastburg, Erikson Institute, Chicago, IL, United States; Linda Gilkerson, Erikson Institute, Chicago, IL, United States

Background: Pediatric residents commonly interact with patients around subjects that are highly charged and emotional. In other helping professions , wellness is supported through mindfulness, attuned interactions, and reflection. Pediatric residency programs may benefit from integrating similar approaches to strengthen resident communication during challenging conversations, grow residents' reflective capacity, and improve doctor/patient relationships. This pilot study investigates the impact of Facilitating Attuned Interactions (FAN) training on building collaborative patient relationships. The intervention consisted of a novel 4 session curriculum delivered during X+Y resident scheduling, consisting of a 3-hour didactic FAN training followed by 3 reflective practice sessions across successive Y weeks.

Objective: To determine if the FAN training and reflective practice will result in improved empathy, mindfulness, self-reflection, and self-compassion among residents, and if the training is satisfactory.

Design/Methods: Sample: n=17 PGY1s, 63% female, mostly between 25-29 years, with broadly distributed career plans. This mixed methods evaluation included Pre-/post-training surveys of self-rated skills in FAN core processes, Reflective Practice Questionnaire, Kentucky Inventory of Mindfulness Skills, and the Self-Compassion Scale. Residents rated the utility of FAN training and participated in a focus group after their final reflective session. We examined changes in ratings from pre- to post-training scales and examined themes in focus groups.

Results: Post-training results showed strong improvement in FAN processes related to patient interactions, modest improvements in the 4 reflective practice sub-components (Fig 1), rated the FAN training as highly satisfactory, and FAN utility in practice as highly useful (Fig 2). Ratings of mindfulness and self-compassion did not change. Preliminary qualitative analysis themes (see table 1), included greater efficiency, efficacy, stronger relationships, less judgement, improved self-regulation, and less vaccine hesitancy.

Conclusion(s): The small pilot sample was underpowered for significance analysis, but the data trends to robust improvements in self-rated attunement and communication skills. Our analysis of the rich qualitative data for 5 focus groups may guide further programmatic and research efforts.

Self Rated FAN Skills and Reflective Practice
Fig 1.jpegComparison of pre and post training FAN skills and reflective practice shows substantial improvement.

Post Training Rating of FAN Training Satisfaction and Usefulness
Fig 2.jpegResidents report that the FAN improved key skills including efficiency, effectiveness, and ability to work with patients that are different from them.

Emerging Themes from Five Focus Groups
Residents report several diverse benefits from the training, from family engagement to acknowledging their own humanity in painful moments in medicine.