Adverse events – broadly defined as experiences that cause significant distress, such as the death of a patient, or an unanticipated outcome — happen frequently in healthcare, and can leave faculty grappling with intrusive thoughts, emotional numbness, anxiety, shame, and difficulty concentrating.

“I think from time to time — either willingly or unwillingly — of the patients I didn’t help,” one surgeon said about struggling with trauma in the aftermath of an adverse clinical event.

Adverse events can have a devastating impact on faculty health professionals, said Jay Watson, MD, Assistant Professor in the Department of Pediatrics-Pediatric Hospital Medicine.

In a 2024 survey of clinical faculty at University of Colorado School of Medicine (CU SOM), 38% of clinical faculty reported experiencing one or more adverse events in the last year.

“Twenty-five percent of our faculty who experienced an adverse event did not receive peer support, or received peer support that was unhelpful. We need to do better, and expanding peer support across our departments is one way to build a culture of support, reduce burnout, and improve the faculty experience,” said Lotte Dyrbye, MD, Senior Associate Dean for Faculty and Chief Well-being Officer.

In partnership with Dyrbye, Jenny Reese, MD, Assistant Dean of Faculty Well-being, is leading the effort to expand a peer support program across CU SOM, starting with a pilot in the Department of Surgery. Reese successfully implemented a peer support program at Children’s Hospital Colorado.

“The data shows a connection between adverse events and burnout,” Reese said. “Burnout leads to error; error leads to burnout. The purpose is to break the cycle as best we can.”

Despite the risks of not seeking support, many faculty members cite significant barriers, including time constraints, confidentiality concerns, fear of career impact, and internalized stigma around vulnerability.

“There is a sense of shame and vulnerability, the feeling of 'I'm the only one that's going through this, and so I will just suffer in silence.’” Reese said. “This, unfortunately, is part of our culture, and we really have to shift that.”

Reese seeks to eliminate barriers to access by equipping trained peers across departments to offer support.

A session with a supporter is not punitive, recorded, nor mandatory. Instead, it offers reassurance through asking, listening, and connecting, both formally through the program, and informally through acculturating a supportive work environment.

“Seeing that your respected peers have been through something like this, that even your successful, experienced peers have had adverse or difficult moments in healthcare; knowing that they seek support; and have navigated through it with resilience, indicates that it is OK,” Watson said. “It removes shame, and shows a culture of it being encouraged to seek support.”

Adds Richard Schulik, MD, MBA, Chair of Surgery and Professor of Surgery-Surgical Oncology, “You can see people are relieved when they see others [can relate], that they’re not an outlier. Just opening that conversation is very important.”

The peer support program, set to expand in the coming months, offers faculty a trained peer with whom to connect, ensuring that faculty members have immediate, trusted colleagues to turn to during difficult times.

“It is important for faculty to know that there is no shame in seeking support,” Watson said. “Seeking support is actually the professionally responsible thing to do, and it shows remarkable resilience. Having support makes me a more energized and engaged provider.”

Additionally, the peer support program aims to foster a caring community wherein faculty are equipped to notice when a colleague is in distress, and to then offer trusted support.

“I think the biggest thing for us all to be on the lookout for is any sudden change of behavior,” Reese said. “If somebody who's typically bubbly and gregarious is suddenly really withdrawn; or someone who's usually super chill suddenly appears really activated or agitated, those can be signs that it would be a good idea to reach out and say, ‘I just want to check in. How are you doing?’”

Reese adds, “We aim to change the culture, that even if a person does not desire to speak to a peer supporter, that overall we're influencing our culture away from shame, blame, and suffering in silence, toward support, vulnerability, and shared ownership.”

Once the program rolls out across departments, faculty members in distress will have resources for peer support, accessible through peer support champions in the department, and through QR codes in workspaces.

“We are setting up an infrastructure so that when you want someone to lean on, the support is readily available, efficient, accessible, and clear,” Reese said.

This initiative aligns with other peer support efforts across CU SOM, such as the peer support that is offered when faculty face legal challenges.

“When a physician or advanced practice provider has an unexpected outcome that results in a notice of claim,” said Abbey Lara, MD, Associate Professor of Medicine and Assistant Dean for Faculty Relations, “There is a sense of ‘What did I do wrong? What could I have done better? What could I have done differently?’ There's that initial inward look of ‘Did I do a patient harm?’ It is a stressful process to go through, because I don't know of anybody in medicine who goes into it wanting to cause harm to patients.”

Additional resources exist across campus, such as the Wingmate Wednesday program in the Department of Anesthesiology, led by Richard Ing, MD, Professor of Anesthesiology.  Wingmate Wednesday is an informal peer support system inspired by the Air Force’s Wingman buddy system. Faculty members are voluntarily paired with a “Wingmate” for weekly check-ins, to foster mutual support and connection. Monthly reminders encourage engagement, helping build trust and camaraderie. This system enables faculty to seek or offer support during personal or professional challenges, creating a culture of peer-driven well-being.

Beyond CU SOM, Colorado Physicians Health Program offers, through their Doc2Doc program, the support of a peer physician for any licensed physician, physician assistant, or anesthesiologist to talk about any issue affecting their well-being.

“A really important part of the conversation is remembering that healthcare providers are still people,” Reese said. “People want someone to talk to who understands what they're going through. We all have these experiences, and it takes courage and vulnerability to talk about them.”

Peer support, while not intended to be a replacement for mental healthcare, can serve as an entry point for mental health resources.

“At this time, providers are experiencing a lot of uncertainty,” said Elizabeth Chamberlain, PhD, Assistant Professor of Psychiatry and Director of Well-Being Programs at the Anschutz Health and Wellness Center. “The changes that are coming constantly are really difficult to navigate.”

For faculty in need of additional support who may be struggling through an adverse event or turbulent times, Chamberlain recommends accessing the comprehensive directory of campus mental health resources available at Anschutz Medical Campus Mental Health Resources.

Of seeking support, Elizabeth David, MD, MAS, Associate Professor of Surgery, said, “If you’re thinking about calling, don’t go down the rabbit hole of ‘Do I call? Do I not call?’ — Just call.”