Stress and burnout among critical care fellows: preliminary evaluation of an educational intervention

Abstract

BackgroundDespite a demanding work environment, information on stress and burnout of critical care fellows is limited.ObjectivesTo assess 1) levels of burnout, perceived stress, and quality of life in critical care fellows, and 2) the impact of a brief stress management training on these outcomes.MethodsIn a tertiary care academic medical center, 58 critical care fellows of varying subspecialties and training levels were surveyed to assess baseline levels of stress and burnout. Twenty-one of the 58 critical care fellows who were in the first year of training at the time of this initial survey participated in a pre-test and 1-year post-test to determine the effects of a brief, 90-min stress management intervention.ResultsBased on responses (n=58) to the abbreviated Maslach Burnout Inventory, reported burnout was significantly lower in Asian fellows (p=0.04) and substantially higher among graduating fellows (versus new and transitioning fellows) (p=0.02). Among the intervention cohort, burnout did not significantly improve – though two-thirds of fellows reported using the interventional techniques to deal with stressful situations. Fellows who participated in the intervention rated the effectiveness of the course as 4 (IQR=3.75–5) using the 5-point Likert scale.ConclusionsIn comparison with the new and transitioning trainees, burnout was highest among graduating critical care fellows. Although no significant improvements were found in first-year fellows’ burnout scores following the single, 90-min training intervention, participants felt the training did provide them with tools to apply during stressful situations.

Brief Online Focused Attention Meditation Training: Immediate Impact

“…22 Brief training is desirable, but studies have shown mixed effects of brief mind-body training on burnout, stress, and empathy. 23 –29…”

Mindfulness Meditation and Interprofessional Cardiopulmonary Resuscitation: A Mixed-Methods Pilot Study

“…19 , 23 , 45–47 To our knowledge, this study is the first of its kind by focusing on an intervention for ICU providers who have been found to have high burnout. 48 There is evidence that those with higher critical positivity ratios have more flexibility and resiliency to adversity, more social resources, and improved well-being 31 and potentially less burnout. We believe our findings of improving the critical positivity ratio are both statistically and clinically significant.…”

WestJEM 21.2 March Issue

“…107 Critical care fellow participants in a SMART program intervention felt the training provided them with tools to apply during stressful situations, but did not demonstrate improved burnout scores. 108 Similarly, Maher found that a departmentally-instituted educational program designed to improve surgical resident performance during stressful scenarios showed a trend toward improved performance scoring but no difference in anxiety levels. However, 91% of residents rated the stress training as valuable.…”

“…However, 91% of residents rated the stress training as valuable. [108][109] While residents and fellows consistently report subjective benefit from resiliency training, improvement in burnout scores have not been reliably demonstrated. Resiliency training is not the only intervention that has failed to show an improvement in burnout scores.…”