Moral Distress Rounds: How to Address Moral Injury and Burnout in Clinical Practice

Monday, April 28, 2025

2:00pm – 3:30pm HST

Location: Convention Center: 323

CE: CME: 1.5
Ethics CME: 1.5

Leader(s)

Meera Singavi, MD (she/her/hers)

Pediatric Hospitalist, Wellbeing Director for Pediatric Hospital Medicine, HRU Medical Director
Phoenix Children's Hospital
Phoenix, Arizona, United States

Co-Leader(s)

Sarjita Shukla, MD

Medical Director, Integrative Medicine Founding Chair, Medical Staff Provider Wellbeing Subcommittee Co-Chair, Graduate Medical Education Professional Wellbeing Subcommittee Physician Lead Phoenix Children's, Healthy Work Environments AACN National Collaborative
Phoenix Children's Hospital, United States
Reina Patel, DO, FAAP (she/her/hers)

Associate Clinical Professor, Child Health
Phoenix Children's Hospital
Phoenix, Arizona, United States
NT

Nehal Thakkar, MD, MBA (she/her/hers)

Pediatric Hospital Medicine, Program Director PHM Fellowship
Phoenix Children's Hospital
Phoenix, Arizona, United States
Roxana Guggenmos, D.O. (she/her/hers)

PHM Fellow
Phoenix Children's Hospital, Arizona, United States
Katherine Dyer, DO, FAAP (she/her/hers)

Pediatric Hospitalist
Phoenix Children's Hospital
Phoenix, Arizona, United States
Michele Scott, MD

Pediatric Hospitalist
Phoenix Children's Hospital
Phoenix, Arizona, United States
Brittany Wold, MD

Pediatric Hospitalist
Phoenix Children’s Hospital
Phoenix, Arizona, United States
Amanda Mihalik, MD, FAAHPM (she/her/hers)

Palliative Care Fellowship Director
Phoenix Children's
Phoenix, Arizona, United States

Disclosure(s):

Meera Singavi, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Krista Gregory, MDiv, N/A: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Sarjita Shukla, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Reina Patel, DO, FAAP: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Henry T. Puls, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Nehal Thakkar, MD, MBA: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Roxana Guggenmos, D.O.: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Katherine Dyer, DO, FAAP: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Michele F. Scott, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Brittany Wold, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Amanda R. Mihalik, MD, FAAHPM: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Workshop Description: Moral Distress (MD) is an emotional and psychological response individuals experience when moral or ethical principles conflict with a given situation or environment. MD is a known contributor to burnout, depression, anxiety, work-life imbalance, and job dissatisfaction. To facilitate discussions and debrief emotions surrounding distressing patient encounters, we created Moral Distress Rounds (MDR) within the division of Pediatrics Hospital Medicine at Phoenix Children’s Hospital.

MDR is a program that was created as a quarterly session, in which participants were introduced to clinical cases of a certain topic that had been identified as causing moral distress. During the session, a facilitator encourages reflection and discussion, rather than problem-solving, while mediating conversations about identifying and mitigating moral distress. In this workshop , participants will learn to design and implement MDR in their home institutions to address rising rates of burnout and moral distress. The session will open with defining MD and providing an overview of the structure of MDR. Example clinical cases will be utilized to identify moral distress triggers in a small group setting. Through a series of role play, reflection, and large/small group discussions, participants will review and employ a toolkit to guide creation and moderation of MDR – all while giving participants the opportunity to practice facilitating example case discussions with feedback. Participants will leave with a resource toolkit to implement MDR at their home institution, including guidelines for facilitators, strategies for overcoming potential challenges, and a sample of the survey “Measures for Moral Distress amongst Healthcare Professionals (MMD-HP)”.

Learning Objectives:

Define moral distress in healthcare workers and identify its triggers within clinical practice.
Apply and synthesize proven techniques to facilitate conversations surrounding moral distress triggers.
Identify the steps, components, and potential barriers of implementing Moral Distress Rounds at home institutions.