The paradox of teaching wellness: Lessons from a national obstetrics and gynaecology resident curriculum.

Background: In response to high rates of burnout among trainees, educators in obstetrics and gynaecology introduced a six-session wellness curriculum that improved professional fulfilment and resident burnout in participants with greater attendance. The implementation of the curriculum varied based on local variables and contextual factors.

Objective: To analyse the reactions of participants and curriculum leaders across the diverse settings of the pilot experience in order to identify the best practices for implementation of a wellness curriculum.

Methods: Twenty-five US OBGYN residency programmes completed the curriculum in the 2017-2018 academic year. OBGYN residents in all the years of training participated. Faculty members and fellows were workshop facilitators and course leaders. All participants completed post-intervention surveys. A qualitative, descriptive thematic analysis explored free-text responses from residents and workshop facilitators.

Results: Among 592 eligible resident participants, 387 (65%) responded to the post-intervention survey. Workshop facilitators submitted 65 surveys (47% response) on curriculum elements, rating the activities as 'good' or 'excellent' in 90.8% of cases. Qualitative analysis of workshop facilitators' and resident comments pointed to three themes, namely disagreement about the purpose of the curriculum, the social value of the curriculum in the residency programme and the need to open a broader discussion and take action to address structural barriers to wellness.

Conclusions: Residents and faculty members involved in a wellness curriculum pilot had polarised reactions. While participants found value in learning skills and connecting to colleagues, efforts to promote wellness skills should be accompanied by communication and action to address drivers of burnout.