Primary care is the cornerstone of healthcare. Yet, increasing demands and administrative burden are some factors straining FPs. Over 60% of FPs report moral injury, with many considering early retirement or narrowing their scope of practice due to chronic systemic issues (1). This attrition is exacerbated by the declining number of graduates pursuing comprehensive family medicine (FM) (2). For years, the College of Family Physicians of Canada (CFPC) has advocated for addressing these issues (1, 2, 4, 5), and some provincial governments have begun to take action (6, 7). However, these efforts have not been sufficient to reduce moral injury (8,9). The challenge of past interventions has focused on micro-level solutions, which fail to address physicians’ frustrations (10).
 
Research examining global occupational distress suggests greater acceptance when solutions focus on cultivating well-being rather than reducing burnout (10). The World Health Organization (WHO) emphasizes rediscovering meaning and purpose, a key principle of NBM (11–14). However, a common misconception about NBM is that it only benefits patients. Critics argue that the application of NBM tools in FD to allay moral injury is a privilege afforded to mid-career FPs, citing Maslow’s hierarchy of needs for early-career FPs. However, robust evidence demonstrates that NBM has had a positive impact on clinicians since the inception of FM (13, 17–31). Despite evidence showing NBM’s effectiveness in fostering professional identity, increasing empathy and alleviating burnout in other specialties, there is a lack of studies on its use in FM FD. Our groundwork included literature reviews and stakeholder consultations with faculty, residents, patients, the CFPC, and the NBM Lab Scientific Committee. 

We then designed a curriculum using the Fundamental Teaching Activities framework (34). Our November 2024 pilot program evaluation demonstrated the feasibility and positive outcomes of this curriculum, reinforcing its effectiveness in achieving the intended educational objectives. FM teachers (n = 10) evaluated the workshop. Before attending, 33% of registrants responded “unsure” whether NBM tools can cultivate well-being, and only 37% had confidence in their knowledge of NBM influencing well-being. Post-workshop (n=6), 100% responded that NBM could cultivate well-being, and all responded with “full” confidence in their NBM knowledge. Three weeks post-workshop (n = 3), two continued to employ NBM. Curriculum changes were made to improve accessibility. The first 25% are didactics to introduce participants to NBM, the rationale, and outline NBM tools and its limitations. Participants then engage in close reading, free writing, visual thinking strategies and generate a personal action plan. Facilitators guide each exercise with prompts, role-modelling, and kindling discussions in small and large groups.

The CFPC’s Education Action Plan emphasizes the need to enhance joy in practice through effective educational approaches, and the University of Toronto is bolstering its curricula to improve resident well-being. Our NBM FD curriculum thus aligns with both national and grassroots educational goals by aiming to understand the factors that influence the perspectives of clinical faculty.