Background/Objectives: Recognizing workforce shortages and adverse impacts of trainee emotional exhaustion, we aimed to measure baseline levels of wellness, resilience, and burnout among pediatric rheumatology fellows as well as to understand the feasibility of implementing a narrative medicine intervention in this population. Methods: This study involved pre- and post-participation questionnaires for pediatric rheumatology fellows in the United States and Canada who participated in a narrative medicine intervention. Survey components included the Mini Z Burnout Survey, the Mayo Well-being Index and the Connor-Davidson Resilience Scale (CD-RISC), baseline demographics and self-reported burnout-related factors. Results: All sixteen invited fellows completed the pre-participation survey, and 15 of the 16 participants completed the narrative intervention. The median (range) baseline CD-RISC resilience score was 73.5 (44–88), and the baseline Mini-Z Burnout Survey showed high levels of burnout with a median (range) of 34 (17–44). The median (range) score of the baseline Mayo Well-being Index was 3 (0–7), with scores of ≥4 associated with physicians at risk of suicidal ideation and/or serious thoughts of leaving medicine. Following participation in the narrative medicine intervention, surveys showed a shift toward feelings that work is meaningful, as well as a shift toward feelings of having time for personal and family life. Conclusions: In this pilot study, baseline levels of wellness, resilience, and burnout among pediatric rheumatology fellows highlighted target areas to mitigate burnout and maximize resilience among fellows. Narrative medicine is a feasible and acceptable intervention, and future larger studies should investigate the possible impact of narrative medicine on burnout among pediatric rheumatology fellows.

Background: Children with juvenile dermatomyositis (JDM) and juvenile idiopathic arthritis (JIA) have increased rates of anxiety and depression (15–65%) when compared to healthy children. Narrative medicine, a group-based intervention that allows patients to reflect on medical experiences, improves patient-reported outcomes with reduces depression rates in adults. Given limited data in pediatric rheumatology, this study assesses feasibility of a patient-targeted narrative medicine intervention and its impact on mental health burden in JDM and JIA. Methods: We prospectively recruited patients ages 6 to 21 with JDM and JIA for a narrative medicine intervention. Participants were divided by diagnosis and age into four narrative medicine groups, with six sessions held over 3 months. Demographic and medical information were collected by chart review. Patients completed pre- and post-intervention questionnaires including Patient-Reported Outcomes Measurement Information System Depression Scale, Generalized Anxiety Disorder-7 (GAD-7), Childhood Attitude Towards Illness Scale, Patient Health Questionnaire-8 (PHQ-8), and CoVID Stress Scale. Results: Twelve patients with JDM (67% female) and nine with JIA (78% female) participated in the narrative medicine intervention. All patients participated in at least 50% of sessions and 91% participated in at least four of the six sessions. Wilcoxon signed-rank test revealed no statistically significant difference between pre- and post-intervention questionnaires for any scales. Sub-analysis of those with elevated GAD-7 and PHQ-8 pre-intervention showed a trend towards improvement in anxiety (p=0.057) and no change for depression (p=0.171). Conclusion: Ninety-one percent participated in at least four of the six sessions, demonstrating feasibility. This exploratory study showed trend toward improved anxiety following narrative medicine session participation for those with elevated GAD-7.

Background: Physician burnout threatens clinician well-being, job satisfaction, retention, and access to care. Pediatric rheumatology faces documented workforce shortages, yet little specialty-specific information exists regarding physician well-being, burnout symptoms, and workplace characteristics. Methods: We conducted a cross-sectional descriptive survey of CARRA-registered pediatric rheumatologists in North America between January and March 2024. Participants completed the Mayo Clinic Well-Being Index (WBI), followed by the AMA Organizational Biopsy^® survey incorporating the Mini-Z 2.0 and demographic/workplace questions. Descriptive statistics summarized physician well-being, burnout symptoms, and workplace characteristics. Differences in WBI scores across response categories for two WBI anchor items assessing work–life integration and work meaningfulness were evaluated using ANOVA. AMA workplace data were available only in aggregate form and could not be linked to individual WBI responses. Results: Of 330 invited pediatric rheumatologists, 164 (49.7%) completed the WBI survey and 145 (88.4%) completed the redirected AMA survey. The mean WBI score was 2.7 (SD 1.9), and 36.0% scored ≥4. On the Mini-Z single-item measure, 48.3% of respondents endorsed at least one category consistent with burnout symptoms; by comparison, 64.0% endorsed the WBI item asking whether they had felt burned out from work during the past month. Frequently reported workplace challenges included documentation burden (56.6%), EHR-related frustration (59.3%), and after-hours EHR work (55.2%). Work–life integration was significantly associated with WBI scores (ANOVA p < 0.001), whereas meaningfulness of work was not (p = 0.26). Conclusions: Indicators of burnout symptoms and occupational distress were common among the responding pediatric rheumatologists. Frequently reported workplace challenges and the observed association between work–life integration and WBI scores identify potential areas for future organizational well-being initiatives.