P4.002: Building Resilience from the Inside Out: Promoting Peer-to-Peer Communities

Background: Pediatric residencies are rigorous training programs that seek to develop compassionate and competent pediatricians. In high acuity, quaternary care settings, residents manage codes, patient deaths, and challenging conversations with families. In primary care, residents support their patients within the framework of socioeconomic disparities. Outside of the workplace, residents also balance personal responsibilities, including changes in support systems, bearing of children, and their own health.

Our hospital system and training program have made efforts to prioritize trainee wellbeing. Nonetheless, residents often seek direct peer support outside of prescribed wellness curricula to build a resilient and cohesive community.

Methods: We established a peer-to-peer support group in September 2023. Senior residents underwent facilitator training by participating in mock sessions, co-facilitating with direct feedback, and completing online Psychological First Aid modules. We conducted opt-in, confidential discussions centered around common themes from the residency experience.

To promote open conversation, sessions were limited to 10 residents and held at a facilitator’s home. All residents were eligible to participate in any and all sessions. We formalized a workflow to appropriately handle disclosed sensitive information, including establishing ground rules for confidentiality, streamlining referrals to program-level support specialists, and maintaining an active list of acute crisis resources.

To evaluate session effectiveness, we assessed resident attendance, discussion themes, and solicited feedback for improvement. We collected anonymous surveys through the Research Electronic Data Capture (REDCap) platform using multiple choice, Likert scales, and free text.

Results: We held 9 sessions during the pilot year. We surveyed participating residents (n=32) with a 44% response rate (n=14). On a 5-point scale where 1= “Not at All” and 5= “Very Much,” respondents expressed that the sessions filled a unique and distinct role for resident support, with a median (interquartile range (IQR)) of 4.1 (4-5). 100% of respondents reported willingness to attend the group if continued. Positive themes expressed in free text responses included alliance across residency classes, the value of brave spaces for challenges and reflection, and promotion of a healthy atmosphere. Areas of improvement included consideration of session structure and optimizing logistics to complement residency schedules.

Due to the positive response after the pilot year, our residency program established funding to continue these sessions annually. Improvements were implemented based on the survey results. We composed distinct themes for each session to guide discussions. We optimized scheduling of sessions to ensure that every resident would have opportunities to participate during an outpatient rotation. We are currently halfway through 8 sessions for the academic year and anticipate collection of feedback in June 2025.

Conclusion: Resident wellbeing can be optimized by fostering spaces for peer-led support. Next steps include iterative improvements based on participant feedback, supplementing facilitator skills, and aiding similar initiatives for other residency or fellowship programs.