The strength of our stories: a qualitative analysis of a multi-institutional GME storytelling event

Figures & data

Table 1. Descriptive statistics regarding event participants and study data

Event Participants
Total # of participants	343
Physicians (all)	197
Residents	132 (67%)
Fellows	14 (7%)
Faculty	51 (26%)
Guests of above physicians	146
Post-event survey
Physicians (all)	129 responses (65% response rate)
Residents	63% (n = 81)
Fellows	8% (n = 10)
Faculty	29% (n = 38)
In-depth follow-up
Total # of volunteers	81 (63% of survey respondents)
Completed follow-up	31 (38% of volunteers))
Email response	28 (90%)
Audio file response	2 (7%)
Phone interview	1 (3%)
Additional data sources
Sticky note reflections^a	129
Twitter posts^a, b	33
Posts with comments	12 (36%)
Re-posted Tweets	16 (48%)

^aSticky note reflections and Twitter posts may be from either physicians or non-physicians. Please see Methods section for further explanation

^bSome posts were by members of the research team who happen to be Twitter users. The posts were in line with their typical use of Twitter and not intentionally informed by this research project; none of those posts were included in this paper.

Table 2. Sample quotes for the themes Connection and Community, Meaning and Purpose, Renewal and Hope, and Gratitude.

Theme	Example Quotes
Connection and Community	I felt connected to people in a way I don’t in my clinical practice. I felt accepted, represented, and thankful for the vulnerability. [survey, faculty #30] I felt a sense of community and connection from this event. [survey, resident #68] Connected me back to my own experiences in training, to my feelings of connection and empathy for current trainees … . [survey, faculty #16] The [power] of stories. They connect us/normalize our common humanity. We laughed, cried and belonged tonight regardless of age, sex, gender, color. [Twitter] I think the sense of connection started at Story Slam [sic]will continue if we make a concerted effort to share our stories of struggle and success with our colleagues. [follow-up, faculty#3]
Meaning and Purpose	Very meaningful experience. I think the shared vulnerability made us all stronger. [survey, fellow #10 (storyteller)] What an incredible event. A safe space to come share what is beautiful and difficult and hilarious about our jobs and training is therapeutic for the medical community. [survey, faculty #9] Incredibly meaningful to share our thoughts and process emotions with supportive colleagues who have gone through the challenges that make up residency. [survey, resident #81 (storyteller)] I have definitely been reflecting more on my experiences in medicine and their impact on me and others after the event. The people who shared really moved me and helped to reinvigorate my love for this practice. [follow-up, faculty #5] This event made me reflect on my own experiences I have had as a resident as well as how these experiences can bind us together as a medical community. Before the Story Slam, I hadn’t realized how much my own stories were weighing on my heart and mind every day. [follow-up, resident #13]
Renewal and Hope	Amazing stories. Made me laugh and cry. Renewed my faith in Medicine. Gave me the will to continue on. [survey, resident #12] We have common themes that haunt, encourage, and sustain us. Sharing tempers the sorrow and expands the joy. I’m replenished. [survey, faculty #37] My heart is full. [sticky note response] This filled my tank. [sticky note response]
Gratitude	Grateful for the opportunity to reflect on medical training and share with an incredibly supportive community! [Twitter] Extremely grateful to be around such thoughtful and genuine people. [survey, resident #45] Thank you to all the learners whom I am supposed to be teaching, for teaching me how to return to myself. [survey, faculty #2] Thank you! We want more of this! [survey, resident #47] The story slam was outstanding. Thank you for all the work that went into bringing together residents and helping us connect. Just awesome. ❤ [resident, text message]

^aSticky note reflections and Twitter posts may be from either physicians or non-physicians. Please see Methods section for further explanation

Table 3. Themes and sub-themes regarding potential impact of storytelling events on burnout

Theme	Sub-Theme	Example quotes
Burnout	Helpful for impacting burnout	Absolutely. I left that evening feeling connected, re-energized, and more empathetic towards my colleagues, especially those who are trainees, and their experiences. Anything that connects us to each other, our shared mission in medicine, and our humanity is protective against burn-out. [follow-up, faculty #1] I do think that storytelling events like this event can help burnout. I think we as a trainee [sic] who work in the medical field come across a variety of stress in both work and outside of work and sharing it, especially sharing the not so great experiences I think is a way to normalize the difficulty that we encounter every day. By normalizing this experience, I think it opens the dialogue we can express more compassion for each other as we understand each other more. [follow-up, resident #1] Yes! It seems a big factor in burn-out is the internal voice that tells physician trainees (and physicians) that they aren’t as good as their peers, that they are the only one struggling with the work, that they shouldn’t be a doctor, etc, etc. The story slam is a way for residents/physicians/students to see that we are all struggling with the same things, and that it helps to share our vulnerabilities with others. This is one of the few ways to breakdown the myth that everyone else is superhuman, never makes mistakes, never suffers from the work. [follow-up, faculty #4]
	Helpful and needs to happen more often	Yes, this can definitely help with burn out. However, I think the effect from the event would only last temporary, unless the culture of sharing story continues. I think this event encourages people to share their story, without feeling ashamed of guilt, or mistake which I [sic] will really help with the burnout. [follow-up, resident #2] Yes, absolutely. As providers in general, we often go to our peers to vent or talk through particularly difficult situations. Whether we are looking for reassurance that we made the right decision, or looking to hear someone say ‘that must have been so frustrating’ it is the people around us going through the same experiences that provide the most support. Even when our spouses, family members, or friends outside of medicine want to help, it is not the same level of understanding or support that those in the medical field can provide. This event is a way in which everyone who participates, whether passively or actively, feels a sense of community, and by extension, feels supported and validated in our feelings. This outlet will absolutely help mitigate burnout, but I think it would need to happen more regularly than once a year. [follow-up, resident #9] Yes, as like an instigating event, but something needs to happen to keep it going through time. And also by like the people you meet at the story event and the people that you hear, you then know you connected with them so you can reach out to them throughout the year, but that you need things like this to keep it going. By itself it can’t by itself mitigate burnout. [follow-up, resident #19 (storyteller)]
	Helpful and systemic changes also needed	I think in a way it can, by sharing stories and letting trainees know that they are not alone and giving a certain amount of validation to similar feelings that may be experienced. I think ultimately though the culture of medicine (duty hours, 24 hours calls, attending bullying, co-residents bullying, limited time to participate in one’s mental health due to other career demands) need to change too. [follow-up, fellow #] I think it is a bit like a flu shot-one will need booster shots to create some degree of protection. Similar to a flu shot, it can reduce the severity of burnout, and it’s not going to be sufficient or 100% effective on its own. Ultimately, we also need to create institutional policies and resources to make our training experiences more humane. [follow-up, faculty #]
	Unlikely to help	No, I think burnout is a result of a larger systems process that begins with the long, competitive, and expensive training process starting with MCATs and going through fellowships. Loved the event, but it will not make up for the 8+ years of delayed gratification, hundreds of thousands of dollars of debt, long work hours, living thousands of miles away from my family, cross cover pages, exhausting work days, low salary, poor diet & decreased exercise during busy months. [follow-up, resident #6] If you are depressed or burned out, one night of storytelling is not sufficient to make you feel better about systemic failures at work. When I was really depressed, events like this made me really angry. I felt like I was right to be angry and depressed and this was a system saying ‘don’t criticize us, just come to this event we are throwing and you will feel better’. But I do think storytelling events are a good occasion to gather with community, which is a positive coping mechanism for any suffering. [follow-up, resident #21 (storyteller)]