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Teaching Wellness Skills: Effect of a Curriculum Designed to Increase Physician Resilience on Obstetrics and Gynecology Intern Burnout, Mindfulness and Self-compassion

Laura E. Fitzmaurice, Brennan D. Peterson, Julia K. Boehm

Obstetrics and Gynecology September 26, 2018 DOI: 10.1097/01.aog.0000546627.20057.36 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Prospective, longitudinal cohort, mixed-methods evaluation Peer reviewed
Sample size 7
Population Obstetrics and gynecology interns in a single residency class
Duration 12-hour curriculum; pre- and post-curriculum assessments
Measures Maslach Burnout Inventory (MBI), Five Facets of Mindfulness Questionnaire (FFMQ), Self-Compassion Scale for Researchers (SCS)
Topics Meditation
Citations 6
Key findings A wellness curriculum targeting resident resilience was associated with an acute worsening of burnout (median increases of 3 in exhaustion and 3 in depersonalization) alongside short-term improvements in mindfulness (median increase 20) and self-compassion (median increase 7). The authors suggest the worsened burnout may stem from increased awareness of uncomfortable thoughts and feelings.

Abstract

Purpose: To assess whether a curriculum targeting psychological resilience impacts the burnout, mindfulness and self-compassion of obstetrics and gynecology interns.

Background: Physician burnout impacts more than half of obstetrician/gynecologists nationwide. One strategy to reduce burnout is to improve individual physicians' resiliency through cognitive and behavioral strategies linked to wellness in other populations.

Methods: A prospective, longitudinal cohort, mixed-methods evaluation of a 12-hour curriculum taught to a residency class of seven obstetrics and gynecology interns was conducted using paired, de-identified, pre- and post-curriculum assessments of Maslach Burnout Inventory (MBI), Five Facets of Mindfulness Questionnaire (FFMQ) and Self-Compassion Scale for Researchers (SCS) scores. Data were analyzed descriptively looking primarily at changes in paired scores. A post-curriculum focus group was conducted to further investigate curriculum acceptance and impact.

Results: Burnout exhaustion and depersonalization scores increased following the curriculum (median difference 3 and 3, respectively). FFMQ and SCS scores also increased (median difference 20 and 7, respectively). Focus group findings suggested interns valued the curriculum, but described an acute increase in distress as they were taken out of their prior “just powering through” coping strategy.

Discussion: A wellness curriculum targeting improved resident resilience was associated with an acute worsening of burnout, but with short-term improvements in mindfulness and self-compassion, both of which have been associated with improved well-being and resilience in other populations. Worsened burnout may have been a result of increased awareness of uncomfortable thoughts and feelings. Extensive further research is needed on how to develop and measure physician resilience, including long-term implications of improved mindfulness and self-compassion.

Comparable studies

Other qualitative studies on meditation, most cited first.

Study Year Design Participants
The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists Western Buddhist meditation practitioners and experts in Theravāda, Zen, and Tibetan... 2017 Qualitative study with mixed-methods
The Effects of Mindfulness-based Stress Reduction on Nurse Stress and Burnout Nurses in a hospital system 2004 Implementation study with mixed methods
An exploratory mixed methods study of the acceptability and effectiveness of mindfulness -based cognitive therapy for patients with active depression and anxiety in primary care Primary care patients with recurrent depression or recurrent depression and anxiety 2006 Exploratory mixed methods study n = 13
A qualitative study of mindfulness‐based cognitive therapy for depression Participants in mindfulness-based cognitive therapy in a mental-health context 2001 Qualitative study n = 7
Effortless awareness: using real time neurofeedback to investigate correlates of posterior cingulate cortex activity in meditators' self-report Meditators 2013 Qualitative study using grounded theory methodology

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