280 - Reflective Rounds: A Way to Restore Meaning in Medicine

Publication Number: 280.6435

Kimiko Dunbar, Children's Hospital Colorado, Denver, CO, United States; Kimberly O'Hara, University of Colorado School of Medicine, Denver, CO, United States; Jennifer Reese, University of Colorado School of Medicine, aurora, CO, United States

Background: Burnout is increasing in healthcare providers throughout the United States with most Pediatric Residents meeting criteria for burnout within 6 months of the start of training. Various interventions have been studied, including debriefing sessions, which have been shown to decrease burnout in certain clinical scenarios, such as the pediatric intensive care unit and pediatric emergency room. This study explored the use of reflective debriefing sessions aimed at restoring “meaning in medicine” for pediatric interns rotating on hospital medicine services.

Objective: To understand common inpatient pediatric scenarios/themes that cause distress in pediatric residents and to assess the impact of debriefing on pediatric residents rotating in hospital medicine.

Design/Methods: Pediatric Interns rotating through the inpatient pediatric hospital medicine (PHM) service were recruited to participate in a 45-minute reflective debriefing session twice during the month-long rotation. Pediatric interns rotating on the sub-specialty gastrointestinal (GI) service were also included given the similarity in resident schedules. Out of two monthly sessions, one was facilitated by a chief resident and the other by a PHM faculty member. All facilitators received specific training and utilized a structured facilitator guide. Residents and facilitators filled out an anonymous survey at the conclusion of each session. This study was conducted over a 7-month period: 12/2023 – 6/2024.

Results: On average, approximately 6 interns attended each session, there were 14 sessions total. 36 intern surveys were completed. Session topics most often included conversations with families but also included difficult diagnosis, conversations with consultants, moral distress and burnout. The sessions were received highly favorably by most participants. 81% of interns reported that the sessions were very effective or extremely effective in increasing meaning in work, 89% of interns reported the sessions were very effective or extremely effective in increasing sense of community and 61% reported that participation in the session decreased their stress level. Most participants felt it would be helpful to have similar debriefs on other rotations.

Conclusion(s): Structured debriefing sessions focused on restoration of meaning in medicine can increase meaning in work, foster a sense of community and decrease stress levels. Future work is currently underway, aimed at assessing the session’s impact on resident burnout and professional fulfillment.

Meaning in Medicine


Sense of Community


Stress Level