Background and objectiveStress and burnout impact resident physicians. This prospective study tests the hypothesis that a mindfulness-based resilience intervention would decrease stress and burnout in residents.MethodsResident physicians from the Departments of Family Medicine, Psychiatry, and Anesthesia at Duke University, Durham, NC, USA, participated in two or three 1-hour sessions of mindfulness-based resilience activities, which introduced mindful-awareness and included practical exercises for nurturing resilience. Anonymous surveys were distributed before (completed by 47 residents) and after the intervention (both completed by 30 residents); a follow-up survey was distributed 1 month later (seven residents completed all three surveys). The survey included the Depression Anxiety Stress Scale, 21-question version (DASS-21), the Oldenburg Burnout Inventory, the Mindful Attention Awareness Scale, and ten questions from the Cognitive Failures Questionnaire.ResultsAt baseline, most residents’ scores were in the normal range with respect to stress; however, female residents had higher DASS-21 scores than male residents (31.7, females vs 18.4, males; P=0.002). Most residents’ burnout scores were in the abnormal range, both with respect to exhaustion (38/47 residents, subscore ≥2.25) and disengagement (37/47 residents, subscore ≥2.1). Higher perceived levels of stress correlated with the instruments. Analysis of the surveys before and after the intervention showed no significant short-term change in stress, burnout, mindful-awareness, or cognitive failure. There was a trend for females and post-medical school graduate year 1 and 2 (PGY1 and PGY2) residents to have a reduction in DASS-21 scores after intervention. There was also a trend of reduced stress and burnout in residents who perceived higher stress.ConclusionResidents who are female, PGY1 and PGY2, and who perceive residency to be stressful may benefit most from a mindfulness-based resilience intervention.

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Purpose-Burnout affects half of doctors in the United States. Programs to decrease burnout and foster resilience are needed to prevent loss of doctors in the workforce and maintain quality care. To ameliorate burnout at our eye center, we developed a resilience program and used a survey to identify additional groups with higher burnout for future interventions. Methods-The eye center-wide resilience program consisted of the baseline burnout survey, short email wellness tips, a grand rounds presentation, short wellness presentations at faculty meetings, and a small group discussion series with clinical faculty. The anonymous burnout survey was performed prospectively online at the beginning of this program. The survey participants consisted of respondents at the Duke Eye Center, including all doctors, scientists, clinical and research staff, trainees, and administrative and educational staff, in June and July of 2017. The short, anonymous electronic survey consisted of 10 demographic questions, 2 validated burnout questions, and 1 validated work-life balance question. Results-A total of 593 individuals were invited to participate, of whom 252 completed the survey. Overall, 37% of the respondents reported being emotionally exhausted, and 17% had experienced depersonalization. With regard to work-life balance, 43% of the respondents were satisfied and 34% were dissatisfied. Burnout was higher in respondents who participated in clinical care (P = 0.001), particularly among ophthalmic technicians (P = 0.044). Feedback from the doctors participating in the "Doctors Lounge" suggested perceived benefits, including enhanced collegiality, life skills, and improved self-management. Conclusions-Our baseline burnout survey showed higher burnout in our clinical workers, particularly in our ophthalmic technicians. Planning for next year will include the providers identified in the survey. We describe the resilience program that we have developed and implemented at our academic eye center, including doctors as well as nonclinical faculty, support staff, and administrative staff, with the recognition that doctors work within a community of caregivers, all of

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