First, Do No Harm: Lessons Learned From a Storytelling Event for Pediatric Residents During the COVID-19 Pandemic.

Problem

The COVID-19 pandemic presented an unprecedented challenge to resident well-being, increasing the risk of anxiety and social isolation. Narrative practices, including storytelling, have been shown to foster resilience and build social bonds. However, whether storytelling is supportive of resident growth and well-being during times of crisis is unknown.

Approach

We recruited 3 pediatric faculty to participate in an interactive 2-hour storytelling and discussion session during a required resident academic half-day session. We used the online videoconferencing platform Blackboard Collaborate. In preparation, faculty attended a 60-minute storytelling workshop (in-person for 2 faculty, online recording for 1 faculty) on finding a story and the elements of good storytelling. After developing their stories, faculty emailed a voice recording of their story draft to the other storytellers, the session facilitator, and a professional storyteller to receive personalized feedback. During the live storytelling session, each faculty shared an 8- to 10-minute story about challenging clinical experiences from which they derived meaning. Stories explored fears of inadequacy, challenging social interactions, patient death, and grief. Faculty related their stories to their current personal and professional lives during the COVID-19 pandemic. After storytelling, faculty facilitated guided discussion about the narrative themes from the stories. A survey was administered immediately following the session using a 5-point scale to investigate: 1) emotions experienced during the COVID-19 pandemic, using questions based on prior work assessing emotional responses to traumatic exposures, and 2) perceived impact of the storytelling session.

Outcomes to Date

Thirty-seven pediatric residents attended the session, and 17 participants (45.9%) completed the survey. Participants included 11 females (64.7%), 5 postgraduate year (PGY)-1 (29.4%), 5 PGY-2 (29.4%), 6 PGY-3 and chief residents (35.3%), and 1 respondent (5.9%) who selected “other” for year in training. Emotions experienced during the COVID-19 pandemic (some, most, or all of the time) included: worried (n = 13, 76.5%), anxious (n = 12, 70.6%), helpless (n = 10, 58.8%), confused/disoriented (n = 10, 58.8%), angry (n = 9, 52.9%), sad (n = 9, 52.9%), guilty (n = 9, 52.9%), afraid (n = 8, 47.1%), and detached (n = 7, 41.2%). The majority of residents reported that it was moderately, very, or extremely true that hearing faculty tell stories was beneficial for their emotional growth (n = 13, 76.5%) and for their professional growth (n = 11, 64.7%) and that they wanted to hear more faculty stories in the future (n = 12, 70.6%). Fewer residents reported that the storytelling was cathartic in the setting of COVID-19 (moderately, very, or extremely true, n = 9, 52.9%). The most common critique provided in the free text comments was that in the setting of COVID-19, stories describing distress and death exacerbated personal stress (n = 5, 29.4%).

Next Steps/Planned Curricular Adaptations

Storytelling may promote emotional and professional growth and may provide catharsis during times of stress. However, stories featuring highly stressful events may exacerbate distress for some. When storytelling events are implemented, trauma-informed practices should be utilized. Listeners should be notified if potentially triggering emotional content will be discussed, should be able to opt out, and should be provided with supplemental resources for emotional support. Stories focused on levity and joy may provide more benefit to residents during stressful times.