Background: High rates of distress and burnout continue to plague physicians. The Sustaining and Training for Resilience, Engagement and Meaning (STREAM) curriculum is a Health Resources and Services Administration (HRSA) funded program, developed by experts in pediatric faculty and trainee wellness from seven academic institutions across the country, to help address this ongoing and pervasive issue. Objective: To describe the evolution of and participant satisfaction with the STREAM program. Design/Methods: STREAM content was developed and iteratively revised to highlight evidence-based/evidence-informed methods to improve well-being, with emphasis on interactive skill-building, such as reflective practice, to support behavior change. STREAM content is grounded in the PERMA-H framework and highlights: Optimizing your Well-Being, Building Resilience, Collaborative Engagement to Improve your Work, and Connecting with Joy and Meaning in Medicine. Within sessions, implementation of skills, such as practicing gratitude, were discussed at the individual level as well as within the work environment. At the end of each session, a 5-question evaluation was completed anonymously by participants. Questions were rated on a 1-5 Likert scale (with 5 being strongly agree), and addressed session relevance, whether material was engaging and interactive, likelihood of recommending STREAM to a colleague, incorporation of DEI principles, and effectiveness of the facilitator. Independent samples t-tests were conducted to determine differences between faculty and trainees. Results: Based on feedback from year one, we moved from a synchronous virtual model to an in-person session model. We increased time with interactive elements (ie individual activities, small group discussions) and limited didactic content. Evaluations were completed by 169 trainees and 131 faculty. Item scores averaged between 3.65 and 4.44. There were no differences between trainees and faculty on items: relevance (p=.11); engagement (p=.61); and facilitators (p=.72). Trainees rated DEI principles (p < 0.001) and recommending to a colleague (p < 0.001) lower than faculty, though average scores for recommendation for trainees was still >4.
Conclusion(s): STREAM sessions were favorably rated for relevance, engagement, and worthiness of recommendation to colleagues. While there are many interventions to improve physician well-being, we need to continue to build the evidence for their effectiveness. The STREAM curriculum delivers in-person, skill-building workshops and is a highly promising model to promote positive behavior change within pediatric academic medicine.
