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Bouncing Back

Bouncing Back

Group Therapy on Tap

Lam, Robert MD; Schiller, Josh MD; Zuckerman, Matt MD

Author Information
doi: 10.1097/01.EEM.0000547205.06342.0e
    storytelling, burnout
    storytelling, burnout:
    An Airway event in Cleveland, June 2017.
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    A crowd has gathered at the local brewery. After the usual greetings, handshakes, and hugs, they settle into their seats around the tables. Orders are placed, and drinks are poured. The lights dim as a speaker rises and starts to tell her story. She describes the typical start of a typical shift and everyone in the room listens, hanging on to each and every word, knowing that something from this shift affected her and is about to affect them.

    As the story concludes, the spell is broken and the audience erupts in laughter. Over the course of the night, stories—sad, humorous, heartwarming, and occasionally off-color—become the catalyst for reflection, vulnerability, levity, and community. The participants will enjoy a greater sense of community and a renewed passion for the difficult work of emergency medicine in the ensuing days. This gathering is one of many storytelling sessions put on across the country to support wellness, increase resilience, and cope with the stress of medical practice.

    “Airway” is a storytelling format born in New York City bars that has successfully spread to national conferences at the AAEM Scientific Assembly, Essentials of Emergency Medicine, and others. When Airway began in 2015, it started as a local event among emergency medicine residency programs in New York City, primarily as a grassroots effort to form a community for EM residents looking for an outlet for the pressures of the ED. Airway organizers found that these events help physicians reflect on their practice, cultivate a sense of empathy, and develop a support network of trusted colleagues.

    Collectively, these events can decrease emotional exhaustion, an important component of burnout. (Acad Med 2015;90[8]:1005.) Reflective practice is also an important tool for improving clinical judgment and developing medical expertise. (Acad Emerg Med 2012;19[8]:978.) Despite these benefits of storytelling, residents and physicians rarely get an opportunity to share their experiences with others in supportive settings. (Clin Med 2001;1[3]:227; http://bit.ly/2vLZIU4.) Airway is the entertaining open mic forum where this happens in front of a live audience.

    Feeling Positive

    Seeking to replicate the benefits seen at the AAEM Scientific Assembly, faculty at the University of Colorado executed and studied the effects of an Airway storytelling event in Denver. A survey was offered to participants and attendees after the event. All of the respondents who had attended said the event left them feeling more positive about working in emergency medicine, and 87 percent said they agreed or strongly agreed that they would attend a future event. The event was considered a success at connecting a wide group of practicing and training physicians from multiple hospitals. A universally positive impression and significant interest have led to two more events with the addition of colleagues from other hospitals with similarly positive reviews.

    The Airway concept has spread organically. Audience members become storytellers and ultimately host an event in their home city. We hope you decide to join. If you are planning to host an Airway-style event, we have learned a few lessons that will facilitate an event that is engaging and authentic:

    • Keep stories brief, no more than five minutes. This ensures that the storytellers get to the point and keep the audience's attention. Nobody likes a poor historian as a storyteller.
    • Do not place any parameters on what is said, other than being HIPAA-compliant and generally respectful. The rest is up to the storytellers.
    • Solicit a few storytellers to prepare in advance of an event to ensure things get off to a good start, but the majority of stories are often from those who join in on the spot. Airway events evolve according to how the participants respond to the group dynamic, and vice versa.
    • Find a location that is private and relaxed. We find that a back room at a bar or brewery provides privacy.

    The organic nature of each event makes the tenor unpredictable, and uncertainty can make sponsoring institutions understandably nervous. EPs have a natural aversion to excessive rules and anything that seems false, however, so spontaneity and authenticity are crucial. When people are encouraged to speak honestly among their peers, the buy-in from residents and staff and the crowd response are magical. Trust in your storytellers and your colleagues. Our chair has become an enthusiastic supporter after seeing the positive effects on the departments involved.

    We work many shifts, but our stories are what stay with us. They bind us together, like soldiers talking of battles fought long ago. Storytelling events work because EPs have the best stories. Guided storytelling events like Airway encourage a humanity-based perspective of medical practice that encompasses the practitioner, patient, and society. Several components of clinical practice such as empathy and reflection are strengthened, and a greater sense of community develops. Participants walk away with a shared experience that reminds them of the significant impact of the work we do.

    Wolters Kluwer Health, Inc. All rights reserved.