{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T18:43:13Z","timestamp":1767638593414,"version":"3.48.0"},"reference-count":36,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000102","name":"Health Resources and Services Administration","doi-asserted-by":"publisher","award":["1U3NHP45413\u201001\u201000"],"award-info":[{"award-number":["1U3NHP45413\u201001\u201000"]}],"id":[{"id":"10.13039\/100000102","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Education and Curricular Development"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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 \u201ca la carte,\u201d depending on the needs of the institution and participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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\u2014and enhance chances of successful education\/training. We must continue to build evidence for the effectiveness of STREAM and other wellness interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23821205251348515","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T03:47:25Z","timestamp":1748836045000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Evolution of a Training Program for Pediatric Faculty and Trainee Wellbeing"],"prefix":"10.1177","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3720-4213","authenticated-orcid":false,"given":"Suzanne","family":"Reed","sequence":"first","affiliation":[{"name":"Nationwide Children's Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie A.","family":"Young","sequence":"additional","affiliation":[{"name":"Nationwide Children's Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josephine","family":"Enciso","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Omoruyi","sequence":"additional","affiliation":[{"name":"McGovern Medical School, The University of Texas Health Science Center at Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Cramton","sequence":"additional","affiliation":[{"name":"Banner University Medical Center-Diamond Children's\/University of Arizona College of Medicine-Tucson, AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larry","family":"Hurtubise","sequence":"additional","affiliation":[{"name":"Nationwide Children's Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Allison","sequence":"additional","affiliation":[{"name":"Nationwide Children's Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Mahan","sequence":"additional","affiliation":[{"name":"Nationwide Children's Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,6,2]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"World Health Organization: Classifications. Accessed October 10 2024. https:\/\/www.who.int\/standards\/classifications\/frequently-asked-questions\/burn-out-an-occupational-phenomenon"},{"key":"e_1_3_3_3_2","volume-title":"Maslach burnout inventory: Manual 4th edition","author":"Maslach C","year":"2018","unstructured":"Maslach C, Jackson SE, Leiter MP. Maslach burnout inventory: Manual 4th edition. Mind Garden, Inc.; 2018."},{"key":"e_1_3_3_4_2","unstructured":"Agency for Healthcare Research and Quality. Accessed October 1 2024. https:\/\/www.ahrq.gov\/prevention\/clinician\/ahrq-works\/burnout\/index.html"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2022-059665"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000000134"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2013.07.016"},{"key":"e_1_3_3_8_2","unstructured":"American Medical Association. Accessed October 2 2024. https:\/\/www.ama-assn.org\/practice-management\/physician-health\/most-pediatricians-have-burnout-here-s-what-it-takes-fix."},{"key":"e_1_3_3_9_2","unstructured":"American Medical Association (AMA) Organizational Biopsy. Accessed October 2 2024. https:\/\/www.ama-assn.org\/practice-management\/sustainability\/practice-transformation-measure"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2018.11.006"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-2163"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-3183"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2020.05.017"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31279-X"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.4300\/JGME-D-20-00359.1"},{"key":"e_1_3_3_16_2","unstructured":"Pediatric Resident Burnout-Resilience Consortium Study. Accessed September 24 2024. https:\/\/pedsresresilience.com\/"},{"key":"e_1_3_3_17_2","volume-title":"Flourish: A visionary new understanding of happiness and well-being","author":"Seligman M","year":"2011","unstructured":"Seligman M. Flourish: A visionary new understanding of happiness and well-being. Free Press; 2011."},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000004634"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.18297\/jwellness\/vol2\/iss1\/7"},{"key":"e_1_3_3_20_2","volume-title":"Wellbeing in the workplace: a comprehensive model and best-practices from top-employers: adaption of PERMA-H","author":"Mayer SC.","year":"2019","unstructured":"Mayer SC. Wellbeing in the workplace: a comprehensive model and best-practices from top-employers: adaption of PERMA-H. University Institute of Lisbon; 2019. http:\/\/hdl.handle.net\/10071\/19676"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s42413-022-00184-4"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.56021\/9781421444116"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.04.015"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpcardiol.2023.101641"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2022.07.016"},{"issue":"3","key":"e_1_3_3_26_2","article-title":"The impact of COVID-19 in reshaping graduate medical education: harnessing hybrid learning and virtual training","volume":"16","author":"Ben Ammer A","year":"2024","unstructured":"Ben Ammer A, Bryan JL, Asghar-Ali AA. The impact of COVID-19 in reshaping graduate medical education: harnessing hybrid learning and virtual training. Cureus. 2024;16(3):e56790.","journal-title":"Cureus"},{"issue":"8","key":"e_1_3_3_27_2","article-title":"Exploration of the role of relationships and virtual learning on academic performance and mental health","volume":"14","author":"Patel D","year":"2022","unstructured":"Patel D, Andersen S, Leon G, Lee C, Simanton E. Exploration of the role of relationships and virtual learning on academic performance and mental health. Cureus. 2022;14(8):e28338.","journal-title":"Cureus"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1177\/0890117118776735a"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.copsyc.2021.07.013"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40596-018-0916-4"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2923.2008.03246.x"},{"key":"e_1_3_3_32_2","unstructured":"Accreditation Council for Graduate Medical Education. Residency review committees common program requirements. Accessed September 13 2024 https:\/\/www.acgme.org\/programs-and-institutions\/programs\/common-program-requirements\/"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12752"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.3390\/bs8110098"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cppeds.2019.100656"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2021.699974"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdx196"}],"container-title":["Journal of Medical Education and Curricular Development"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23821205251348515","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23821205251348515","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23821205251348515","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T14:47:07Z","timestamp":1767624427000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/23821205251348515"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,2]]},"references-count":36,"alternative-id":["10.1177\/23821205251348515"],"URL":"https:\/\/doi.org\/10.1177\/23821205251348515","relation":{},"ISSN":["2382-1205","2382-1205"],"issn-type":[{"type":"print","value":"2382-1205"},{"type":"electronic","value":"2382-1205"}],"subject":[],"published":{"date-parts":[[2025,6,2]]},"article-number":"23821205251348515"}}