Palliative Care-Led Weekly Debriefs in the Medical ICU: A Novel Intervention to Improve Resident Wellbeing

Abstract Background Resident physicians have high rates of burnout, particularly in the medical ICU (MICU) given its high acuity, rigor, and census. However, there have been limited interventions to address burnout/coping of residents in the MICU. Objective We aimed to evaluate resident perspectives on emotional burnout and coping before and after the launch of a palliative care-led debrief pilot in the MICU of our academic medical center. Methods Participants in the pre- and post-intervention phases included Internal Medicine (IM) and Medicine-Pediatrics (MP) residents during the 2022-2023 (pre) and 2023-2024 (post) academic years who were surveyed on self-reported burnout and coping. Participants in the intervention phase included IM and MP residents who rotated in our MICU between April 2023 and April 2024 and attended the debriefs. Results 48 (24%) residents participated in the pre-intervention survey, and 61 (31%) participated in the post-intervention survey. Pre-intervention, residents reported emotional burnout as 3.67 (on a scale from 1=low to 5=high burnout) and emotional coping as 3.48 (on a scale from 1=lower to 5=higher ability to cope) in the MICU, compared to 3.58 (P = 0.67) and 3.66 (P = 0.24), respectively, post-intervention. 35 (66%) respondents who had rotated in the MICU during the intervention participated in the sessions, attending 1 (57%), 2 (23%), or 3 + (20%) sessions. 28 (93%) agreed or strongly agreed that the debriefs were useful/helpful. Conclusion Resident emotional burnout and coping showed a possible trend towards improvement, though this was not statistically significant and longer-term studies are needed. These debriefs were feasible and valued by trainees.