Reed Suzanne, Young Julie A, Enciso Josephine, Omoruyi Emma, Cramton Rachel, Hurtubise Larry, Allison Katherine, Mahan John
Department of Pediatrics, Nationwide Children's Hospital/The Ohio State University College of Medicine, Columbus, OH, USA.
Department of Pediatrics, University of California Los Angeles, CA, USA.
J Med Educ Curric Dev. 2025 Jun 2;12:23821205251348515. doi: 10.1177/23821205251348515. eCollection 2025 Jan-Dec.
High rates of distress and burnout continue to plague physicians. The Sustaining and Training for Resilience, Engagement and Meaning (STREAM) curriculum is a Health Resources and Services Administration (HRSA) funded program, developed by experts in faculty and trainee wellbeing from 7 academic institutions, to help address this ongoing and pervasive issue.
We used Kern's 6-step model to develop the STREAM program. STREAM content was developed and iteratively revised to highlight evidence-informed methods to improve wellbeing. STREAM content is grounded in the PERMA-H framework and highlights 4 pillars: Optimizing your Well-Being, Building Resilience, Collaborative Engagement to Improve your Work, and Connecting with Joy and Meaning in Medicine. Within sessions, implementation of skills was discussed at the individual level and within the work environment. This manuscript describes the process of development, implementation, and pilot program evaluation for the STREAM curriculum for the first 2 years.
Based on review and assessment of year 1, we made multiple revisions of the curriculum. We revised the original four pillars and strengthened connection with the PERMA-H model. We transitioned from synchronous virtual model to in-person sessions to enhance engagement, buy-in, and meaning. We further increased time with interactive elements and limited didactic content. We deepened content related to equity and inclusion. We separated faculty and resident sessions to improve community-building and group dynamics. Additionally, we provided the option for sessions to be delivered "a la carte," depending on the needs of the institution and participants.
The STREAM wellbeing curriculum is a promising model to promote positive behavior change in pediatric academic medicine. Curricular activities related to wellness may require adjustment and modifications while in process to improve delivery and participation-and enhance chances of successful education/training. We must continue to build evidence for the effectiveness of STREAM and other wellness interventions.
高压力和职业倦怠率持续困扰着医生。“恢复力、参与度和意义的维持与培训”（STREAM）课程是一项由卫生资源与服务管理局（HRSA）资助的项目，由7所学术机构中专注于教员和学员身心健康的专家开发，旨在解决这一长期存在且普遍存在的问题。
我们采用克恩的六步模型来开发STREAM项目。STREAM的内容经过开发和反复修订，以突出基于证据的改善身心健康的方法。STREAM的内容以PERMA - H框架为基础，突出四个支柱：优化你的身心健康、培养恢复力、通过协作参与改善工作、在医学中找到快乐和意义。在课程中，讨论了在个人层面和工作环境中技能的应用。本文描述了STREAM课程头两年的开发、实施和试点项目评估过程。
基于对第一年的审查和评估，我们对课程进行了多次修订。我们修订了原来的四个支柱，并加强了与PERMA - H模型的联系。我们从同步虚拟模式转变为面对面授课，以增强参与度、认同感和意义。我们进一步增加了互动元素的时间，并减少了说教内容。我们深化了与公平和包容相关的内容。我们将教员和住院医师的课程分开，以改善社区建设和团队氛围。此外，我们还提供了根据机构和参与者的需求“单点”授课的选项。
STREAM身心健康课程是促进儿科学术医学中积极行为改变的一个有前景的模式。与健康相关的课程活动在实施过程中可能需要调整和修改以改善授课和参与情况，并提高成功教育/培训的机会。我们必须继续为STREAM和其他健康干预措施的有效性积累证据。
