Our Programs for Medical Students and Residents
Conscientious, driven, idealistic, and passionate, medical students and residents are our future healthcare practitioners and leaders. Yet these admirable traits may make them particularly prone to anxiety, depression, and burnout.
Studies show that the prevalence of depression and burnout in medical students is higher than the age-matched general population, other college grads, and is predictive of suicidal ideation. Up to 50% of medical students experience burnout and 10% report suicidal ideation. While factors contributing to this are still being defined, it is likely that a culture that is hierarchical, highly competitive and demanding, repeatedly induces sleep deprivation, and tolerates little margin for error contributes to high rates of burnout and mental health issues.
Traditional medical training, with its strong emphasis on knowledge acquisition and efficiency, has historically neglected to formally teach or acknowledge the importance of skills that facilitate connection and well-being. Self-compassion, mindfulness, setting and respecting boundaries, emotional intelligence, and leadership skills CAN be learned and are essential in developing resilient physicians who can advocate for themselves, and remain engaged and connected to the meaning in their work over the course of a career.
The use of equine facilitated learning with medical students was pioneered by Dr. Allan Hamilton at The University of Arizona in 2001 and has been replicated in other programs both across the country and internationally. Dr. Artz is partnering with UnityPoint Health to train medical students and residents who rotate within the UnityPoint system. Medical students from the University of Iowa who are completing their third year clerkships at UnityPoint spend one day/week for three weeks at Monarch gaining important skills focused on increasing resilience and well-being. Internal Medicine residents can elect to complete a two-week elective rotation with an extended curriculum that delves more in depth into leadership skills including handling conflict productively, and leading challenging conversations with patients or colleagues.
Eliciting change and influencing others in a positive direction must begin with changing ourselves. We anticipate the benefits of this program will extend beyond the internal changes in the students and residents to the patients and families they care for – now and throughout their careers.
What our learners have to say
Throughout this year I had noticed myself feeling more and more exhausted by my work and losing a lot of the joy that my work had brought me. I seemed to be treating my patients more callously and some days just felt like a chore to get through. My fuse was getting shorter and shorter and little things, which were really not important in the bigger scheme, were making me blow up. This elective was honestly the most valuable rotation I did all year because it helped me to figure out a way to work through the emotional difficulties of residency without losing the joy that medicine brings me. Thanks to this elective, I learned to see challenges, whether with patient care, coworker relationships, or just day to day life, as an opportunity for growth, and to work through frustration without letting it turn into anger. I learned to stay more present in my interactions with others and to treat myself with the same compassion that we give our patients. I also re-committed to putting in the work to practice the small acts of daily self-care necessary to keep my tank filled and to be my best self even when things are tough.
The Hoofprints and Heartbeats program was a wonderful opportunity to learn how to engage when outside your comfort zone. I learned about setting boundaries, multiple approaches to create a connection, and the importance of establishing a relationship based on trust. In addition to learning about patient care, there is a strong component of reflection, application to the patient care, and self-care. I would recommend anyone in the healthcare field to partake, especially those who feel burned out. This was a rejuvenating and rewarding experience!
The University of Iowa
The elective did a great job of teaching us how individuals may react differently when they are scared, nervous, or unsure about something and that the manifestation of this is often very subtle. In addition, the elective taught some really effective ways to manage stress and help prevent burn out that I will continue to implement going forward.
Before “Hoofprints and Heartbeats” I had never interacted with horses. During the program I learned that horses have a special way of using non-verbal communication. I was able to work with a magnificent bay horse named Kismet during an activity where we helped the animals gain comfort around unfamiliar objects. Leading them through the course while making sure they were comfortable helped me pick up on the non-verbal hesitation they were feeling. This experience helped me learn connection which will be helpful with patients. Thank you Dr. Artz!
The University of Iowa
The horse activities reminded me that building relationships is an iterative process and reminded me to be patient and committed to working through things over time rather than expecting instant results. The equine activities also helped me to to find a way to be present in the moment. The daily meditation and gratitude journals helped me to rediscover all the joy that my work brings me.
Getting away to this calm and relaxing atmosphere was great for personal wellness, but also helped me to be able to step back and work on what my true self actually entails. This career can be pretty stressful, and engender an unhealthy cycle of negative experiences and anxiety. The experience influenced me to work on ways to calm myself. It helped me search for ways to understand and learn from non-compliance or other frustrating situations rather than let emotions take hold.
The University of Iowa
Working with the horses really helped me understand the importance of being clear with my actions. It also helped me understand how much my nonverbal cues and energy can impact others around us.
I will definitely continue to do the burnout prevention so that I can be more present for patient care. I will also now be able to see behavior such as passive resistance from patients as potentially stemming from a fear or hesitation on their part rather than just willful non compliance.
Often in medicine, we are dealing with deeply emotional situations, and it can be difficult not to get wrapped up in it. This elective will help me remember to pause and be more intentional with my actions. It also reminded me how important it is to take care of myself physically and emotionally.
I will always be grateful to this elective and to Dr. Artz for giving me the tools to continue through my training without losing my sense of self or my joy and passion for medicine. I have no doubt that I was experiencing many of the negative feelings associated with burnout and it was definitely starting to bleed into my personal life. I now feel better equipped to combat burnout throughout my training as well as in independent practice. I am confident that not only will I provide more effective and compassionate patient care because of this elective, but that I will also be happier and more fulfilled in my career.
I just wish I would’ve had this every year starting intern year! The stress reduction and impact on my patient care throughout residency would have been very positive.
An investment in our learners is an investment in the future of healthcare.
Students and residents who have learned to be more mindful and aware of the way they are interacting with others and who have developed skills contributing to resiliency will influence the health of our community and the world beyond over the course of their career. Investing in our medical students and residents is investing in the future of our healthcare systems and communities.
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