(1067) "I See You": Structured Debrief Sessions for Medical Students on Critical Care to Develop Resiliency

Introduction: Medical student wellbeing and resiliency is essential to the future of medicine. Students are exposed to difficult end of life situations as well as impactful emotionally charged events. The Institute of Medicine and the ACGME acknowledge the importance of promoting the psychological, emotional, and physical well-being of trainees to create competent, caring, and resilient physicians, but there is a lack of targeted medical student education in combating physician burnout. This project established debriefs for 4th year medical students during a required ICU course. We hypothesized that we would benefit students by sharing experiences, discussing resiliency skills, and providing an open forum for discussion of other impactful situations that arose.

Methods: One hour debriefs were facilitated by critical care faculty, palliative care, resiliency clinicians, and ethicists during the last week of the ICU rotation. At completion, students completed an anonymous Redcap survey. This included demographic data, brief question sets (1-5 Likert scales) targeting burnout and wellbeing factors, and free text questions on their ICU experiences, value of the session, and takeaways. Descriptive statistics were used to assess survey items.

Results: 119 medical students participated. Surveys showed that factors associated with positive aspects of wellbeing were negatively correlated with feeling less interested in talking to patients (p≤0.05). Factors associated with burnout were positively correlated with feeling less empathetic toward patients, less connected with patients, less connected with colleagues, and less sensitive to others’ emotions (p≤0.05).

Qualitative analysis showed that ICU resilience promoters included social support, downtime, and share experiences with faculty and colleagues. Resilience inhibitors included long hours and large workloads, challenging clinical cases, and workplace management issues.

Conclusions: Medical students found the debrief process beneficial. It promoted the discussion of coping mechanisms, resiliency building, and shared experiences. We recommend incorporating scheduled debriefings into medical school training, especially around critical care rotations to promote wellbeing.