Does it Spark Joy? Cultivating Joy and Resilience Through Art Based Reflection in the Pediatric Clerkship

Context Medical students face risks of burnout, emotional distress, and erosion of empathy during clinical training. Reflecting on positive clinical experiences can potentially buffer against burnout, strengthen professional identity, and improve emotional well-being (1). Engaging in art journaling to facilitate reflection can foster emotional insight and resilience (2). There is limited research on the use of visual art reflection on positive clinical experiences among medical students. Previous analysis of a visual art reflection exercise in the JABSOM Pediatric Clerkship showed a slight increase in students’ overall perception of their third year medical student experience and increased sense of engagement and connectedness with both their classmates and their patients. To look at further potential impact on their future careers as physicians, we surveyed students to look at how the activity affected perceptions of joy in clinical work. Objectives To evaluate whether drawing a joyful clinical memory can improve perceptions of joyful moments, identification of strategies to preserve joyful moments, and retention of meaning in clinical work among medical students. Evaluate the feasibility and perceived usefulness of art journaling in medical education. Description of Innovation Halfway through each 4 week long inpatient block of the pediatric clerkship, small groups of approximately 8 third year medical students participated in a brief 30 minute group activity. Individual identifying information or other demographic factors were not collected from students. Students were asked to draw a picture of a joyful or meaningful moment from their first two weeks of inpatient pediatric clerkship. Each student shared their picture with their group, explained why the particular experience brought joy, and how they could find similar moments of joy in their future career as a physician. Students completed an anonymous survey at the end of their inpatient block. Qualitative themes of the activity were also analyzed. Evaluation of Innovation To date, 23 students completed the activity and a post survey during the current academic year. The majority drew a relationship forged with a patient while 1 depicted camaraderie with the medical team. Mean survey scores based on a Likert scale rating of 1 to 5 (5=strongly agree) showed that the students felt the activity helped process experiences during the pediatric clerkship (4.00), recognize what brings joy in clinical medicine (4.39), protect moments of joy in future medical practice (4.17), identify new future strategies to incorporate in their medical practices (3.96), and highly recommended this activity for other students (4.09). 43% of free responses commented that the exercise helped reinforce their reason for pursuing medicine. Discussion Through a brief visual art reflection activity, students can recognize moments of joy in a busy inpatient rotation and identify strategies to protect moments of joy in their future medical careers, particularly through empathetic interactions with patients and revisiting their personal motivations for pursuing a physician career. These behaviors may produce physicians who are more attentive to equity, patient dignity, and strengths-based care. Visual art reflections are more accessible for students from diverse linguistic backgrounds in comparison to traditional written reflections. In addition to ongoing evaluation of this teaching innovation this academic year, future considerations include expanding this activity to other clerkships to provide longer term engagement that may potentially lead to decreased feelings of burn out or empathy erosion during medical school. Future directions also include following students at the end of the third year with validated tools to measure well being to assess for long term impact.