Using narrative medicine to enhance self-compassion and reflective capacity in pediatric residents

Abstract Paediatric residency is a formative yet demanding period characterized by emotionally charged patient encounters, high expectations, and personal and professional growth. These challenges can contribute to emotional fatigue and disconnection. Strengthening physicians’ capacities for reflection and self-compassion may promote resilience and sustain compassionate care. Self-compassion involves responding to one's own suffering with mindfulness, kindness, and awareness of shared humanity, while reflective capacity refers to the ability to critically examine professional experiences. Narrative medicine has shown promise in fostering compassion, perspective-taking, and professional fulfillment, but evidence within paediatric residency remains limited. This study evaluated whether participation in a narrative medicine reflective group using the Parallel Chart exercise improved self-compassion and reflective capacity among paediatric residents and assessed the acceptability of this intervention. A single-group exploratory pre-post study was conducted among McMaster University paediatric residents (postgraduate years 1 to 4). Participants attended up to six one-hour sessions co-facilitated by a paediatric resident trained in narrative medicine and a postgraduate counsellor. Sessions included reflective writing about meaningful patient encounters followed by guided discussion. Self-compassion and reflective capacity were measured using validated questionnaires, and qualitative feedback was analyzed thematically. Participation in the Paediatric Awareness and Understanding of Salient Encounters (PAUSE) narrative medicine sessions improved self-compassion and reflective capacity scores. Qualitative analysis identified themes of enhanced mindfulness, compassion, shared humanity, and meaning in clinical work. Participants described the sessions as restorative, validating, and supportive. The PAUSE narrative medicine intervention suggests that structured narrative medicine may provide a sustainable approach to promoting wellness, reflection, and humanism in paediatric residency training.