Program Goals: 1) Create a cohesive and resilient Hospice and Palliative Medicine (HPM) fellowship class 2) Nurture a sustainable and resilient Palliative Care team, Hospice Interdisciplinary Team and other trainee class 3) Effectively utilize unique, combination strategies to forge understanding, trust and support among team members Evaluation: Two years of pilot data indicate that the HPM fellows found that these activities are meaningful, enabled them to forge supportive relationships with other fellows and gave a greater sense of cohesiveness. The fellows have been able to support each other not only through the stress of fellowship training but came together for life crises that occurred during the training years. Fellows have used the skills learned to adapt and teach other trainees and interdisciplinary team members, leading to improved team understanding and resiliency. Discussion: Hospice and Palliative Medicine (HPM) fellowship is a one-year, high stress period in which fellows with diverse backgrounds and experiences learn how to care for patients and families with serious illness. During this year, the clinical fellows are physically separated from each other as they rotate through different disciplines (adult and pediatric), settings (hospital, outpatient clinics, home), and work with various medical and psychosocial staff, which collectively may lead to feelings of social and emotional isolation. Fellows observe and partake in innumerable difficult conversations and medical situations potentially leading to feelings of ethical and/or moral distress, and compassion fatigue. Finally, during this brief clinical experience, fellows must acquire resiliency and self-care skills enabling them to thrive in a difficult year of training and will sustain them for a career in palliative medicine. Initiated during orientation to fellowship and continued throughout the year, a number of activities are utilized to forge and further supportive bonds between the fellows. These include an introductory, facilitated discussion reviewing fellows’ personal career and life path and reasons for choosing HPM, the creation of a personal Hippocratic Oath, and a sand tray exercise for clinical fellows led by a psychology nurse allowing fellows to choose and discuss the objects of importance. These activities are followed up with monthly, 90-minute group "debriefings" for all clinical fellows with the nurse who is unaffiliated with the training program. The strategies that have been utilized in HPM fellowship at University of TN. We think could be adapted and used for other training programs. We hope that the presentation, poster or oral, would enable discussion and cross-pollination of ideas to mitigate burnout in a variety of medical subspecialties and primary care areas.
Creating a Cohesive and Resilient Hospice and Palliative Medicine Fellowship Class
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Amanda Linz, Jennifer Snaman, Brenda Wiseman, Melody J. Cunningham; Creating a Cohesive and Resilient Hospice and Palliative Medicine Fellowship Class. Pediatrics May 2018; 142 (1_MeetingAbstract): 91. 10.1542/peds.142.1MA1.91
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