1. Pediatric Hematology-Oncology Fellows’ Physician Well-Being Sessions Claire M. De Souza BSc MD FRCP(C) Hospital for Sick Children, University of Toronto, Toronto, Canada Burnout amongst physicians has been well described as have supportive programs for Hematology-Oncology Fellows. At the Chief Fellows’ request, a workshop on coping strategies was given in 2005 followed by monthly well-being sessions at the Hospital for Sick Children beginning in 2006. The initiative was supported by the Chief and Fellowship Director for the Division of Pediatric Hematology-Oncology. Background To develop a curriculum on the topic of Physician Well-Being for Pediatric Hematology-Oncology Fellows through which sources of stress can be discussed Purpose Methods Conclusions References Needs assessment focus group (2006): 9 interdisciplinary team members (staff MDs, RNs, resident, SW) + 2 parents survey of fellows: informal (2006/7), formal (2008) Sessions – 1 hr / month topics advertised mixed didactic and interactive teaching methods articles referenced Staff Oncologists present to emphasize importance refreshments provided Session Evaluation Physician Well-Being sessions were valued by those in attendance. Participating fellows represented a diverse group with varied needs. Attendance was limited and barriers to participation need further exploration. The collaboration can be a rewarding experience for a consulting psychiatrist. Results: Needs Assessment (Topics) Armstrong J, Lederberg M, Holland J. Fellows' forum: a workshop on the stresses of being an oncologist. J Cancer Educ. 2004: 19(2):88-90. Armstrong, J and Holland, J Surviving the Stresses of Clinical Oncology by Improving Communication. Oncology. 2004: 18(3):p363-375. Grunfeld E, Zitzelsberger L, Coristine M, Whelan TJ, Aspelund F, Evans WK. Job stress and job satisfaction of cancer care workers. Psychooncology. 2005; 14(1):61-9. Sekeres MA, Chernoff M, Lynch TJ Jr, Kasendorf EI, Lasser DH, Greenberg DB. The impact of a physician awareness group and the first year of training on hematology-oncology fellows. J Clin Oncol. 2003; 1;21(19):3676-82. Spinetta JJ, Jankovic M, Ben Arush MW, Eden T, Epelman C, Greenberg ML, Gentils Martins A, Mulhern RK, Oppenheim D, Masera G. Guidelines for the recognition, prevention, and remediation of burnout in health care professionals participating in the care of children with cancer: report of the SIOP Working Committee on Psychosocial Issues in Pediatric Oncology. Med Pediatr Oncol. 2000 ;35(2):122-5. Acknowledgements Drs. Ahmed Naqvi, Angela Punnett, Michael Capra, Victor Blanchette, and Tony Truong n=14 Respondents: 70% female, 64% 1st year, Grad Yr: 91-03, 86% Internationally trained (Europe, Middle East, India, Africa) 92% were in favour of Well-Being sessions 71% attended Well-Being sessions at SickKids 62% felt the topic of Well-Being is important Majority preferred: case based discussion, every 1-2 months Results: Needs Assessment / Evaluation (2008) Year # SessionsEducational Climate 2006/79Preference for interactive over didactic, fellows only 2007/811Preference for more structure & less focus on ‘personal’ experience, topics advertised, staff oncologists present; cultural differences noted 2008/92Change in Fellowship director: focus on integrating well-being sessions into existing curriculum 2009/106Fellowship curriculum: modified to academic half- days (from weekly 1 hour sessions) to enhance attendance with the plan to integrate 6 well-being sessions Results: Session Evaluations “What I Liked” facilitated interactive discussion brainstorming, reflection relaxed and open approach relevant topics matching needs communication skill development hearing from group including staff oncologists references “What I Didn’t Like” need more time for topics poor attendance by fellows “What I Will Apply” relationship with patient, care for self, structured approach, reflection Disclosing Medical Error · Team Communication Breaking Bad News · Talking with Kids about Death/Dying Collegiality ∙ Caring for Self Challenging Families · 1 st 24 hours Mentorship · Transition to Practice Cited as a strength of the Fellowship program during the Royal College of Physicians and Surgeons On-Site Survey (2007) National Videoconference on topic to 10 Pediatric Hematology- Oncology centers in Canada Hematology-Oncology Nurses requested well-being sessions Impact Sessions: 5 to 10 fellows on average (N.B. 20-25 clinical fellows in program; more than half are internationally trained) Needs Assessment (2008): 14 fellows completed survey Results: Participation