Background: Emergency Medicine (EM) urgently needs evidence-based strategies that can have a positive impact on the burnout crisis. While mindfulness has been shown to reduce burnout in physicians, there are no studies involving EM residents. The objective of this study was to test whether or not a novel EM-centered mindfulness training would reduce resident’s levels of burnout and perceived stress.
Methods: We conducted a cohort study of 60 EM residents who received a 2.5 hour mindfulness training during their annual resident retreat. The training was developed and delivered by an EM physician (JO’S) and a certified Mindfulness Based Stress Reduction teacher (MD). Subjects completed the Maslach Burnout Inventory, Perceived Stress Scale and Mindful Attention and Awareness Scale at three time points. Time 1 - 1 week prior, Time 2 – 1 week post, Time 3 – 1 month post. We also collected data on the resident’s frequency of implementation at home and on shift, and their intention to use in the future. This study was deemed exempt by the Emory IRB. A financial incentive was used and completion rates were 70%, 60% and 50% respectively.
Results: The subjects were 60 EM residents (54% male, 46% female) with an average age of 29. In the month after the retreat, 64% of residents used the techniques at least 2 or 3 times a week on shift and 52% used them at least 2 or 3 times a week at home. We found that Perceived Stress (η2 = 0.17, p = .003) and Emotional Exhaustion (η2 = 0.23, p = .0007) decreased significantly over time in a linear progression across the three time points. Emotional exhaustion is recognized as a critical factor in burnout.
Conclusion: Mindfulness training tailored to an EM audience is acceptable, readily adopted for practical use on shift, and significantly reduces both perceived stress and emotional exhaustion among EM residents. Such training should be further studied with a randomized controlled trial using multiple different training sites and incorporated into EM curricula.