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Can Stress Management Intervention Prevent Medical Resident Burnout?

The impact of stress on medical residents continues to be a major concern in the medical community, given that the well-being of practitioners is critical for the quality and safety of patient care.

Factors such as heavy patient workload, long working hours, poor work environments, lack of social support, and difficult interactions with patients and their families are known to contribute to high levels of burnout among health-care practitioners — the mental, physical, and emotional exhaustion that is the result of a constant exposure to stress.

University of Florida scholar Carma Bylund and a team of researchers wanted to explore if offering a stress management intervention to medical residents would provide immediate and sustained relief from workplace stressors.

To investigate this, the researchers designed a one-day workshop for medical residents at Hamad Medical Corporation in Doha, Qatar, to help residents identify stressors and early warning signs of stress, and to provide residents with the tools needed to practice intervention techniques on their own after the workshop.

The workshop included a lecture on stress and wellbeing that focused on the concept of stress and detection of job stressors and stress outcomes, as well as relaxation techniques, cognitive restructuring, and time management. Residents then spent time in large and small group discussions, where they discussed theoretical information about stress, and reviewed real case scenarios. They were then asked to practice the principles of stress management through case study, further discussion, and active practice.

The findings were positive overall. More than 60 percent of participants strongly agreed that they would recommend the workshop to other colleagues and would be interested in attending advanced workshops on the same subject. In the course evaluation, 92 percent of the participants listed at least one skill they learned in the workshop that they could put into practice moving forward, including breathing exercises, sleep hygiene, and cognitive reframing.

According to a post workshop survey at the one-month mark, 84 percent of participants said they had put into practice at least one technique. Breathing exercises was the most-reported technique, with 80 percent of respondents putting that technique into practice. The researchers believe that is because this technique is the most portable, the easiest to engage, and can be applied at any time.

The second most applied technique was sleep hygiene, but that practice was met with limited success. Forty percent of respondents reported an intention to try it post-workshop, but in the follow up survey, only 11 percent of respondents reported actually implementing it. Given the critical nature of sleep with regards to physician well-being and patient safety, the researchers find this to be a notable opportunity for further study.

Of particular note is that, while participants overwhelmingly remembered the training post-workshop and put it into practice, post-course results also showed a statistically significant increase in “Satisfaction with Medicine.” In comparing pre- and post-workshop data, researchers also saw scores improve in the categories of “Emotional Exhaustion” and “Depersonalization.” They found this very promising overall and important data for prompting further study in this area.

These findings were previously presented at the Accreditation Council for Graduate Medical Education Annual Conference, National Harbor, Maryland: February 2016.

Authors: Jess Ghannam, Ph.D., Department of Psychiatry, University of California – San Francisco; Abdelhamid Afana, Ph.D., Department of Psychiatry, Hamad Medical Corporation; Evelyn Y. Ho, Ph.D., Department of Communication Studies, University of San Francisco; Abdullatif Al-Khal, M.D., Department of Medical Education, Hamad Medical Corporation; Carma L. Bylund, Ph.D., University of Florida College of Journalism and Communications Associate Public Relations Professor and Associate Professor, College of Medicine Division of Hematology & Oncology.

This summary was written by Marie Morganelli, Ph.D.

Posted: August 29, 2019
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