Stress and burnout in residents: impact of mindfulness-based resilience training.

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BACKGROUND AND OBJECTIVE: Stress and burnout impact resident physicians. This prospective study tests the hypothesis that a mindfulness-based resilience intervention would decrease stress and burnout in residents. METHODS: Resident 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. RESULTS: At 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. CONCLUSION: Residents 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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Goldhagen, Brian E, Karen Kingsolver, Sandra S Stinnett and Jullia A Rosdahl (2015). Stress and burnout in residents: impact of mindfulness-based resilience training. Adv Med Educ Pract, 6. pp. 525–532. 10.2147/AMEP.S88580 Retrieved from

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Karen Odessa Kingsolver

Assistant Professor in Psychiatry and Behavioral Sciences

Sandra Sue Stinnett

Associate Professor of Biostatistics & Bioinformatics

Analysis of data for ophthalmology including observational studies and clinical trials. Assessment of reproducibility in grading measurements for ophthalmic studies. Teaching medical statistics.


Jullia Ann Rosdahl

Associate Professor of Ophthalmology

I am a glaucoma specialist at the Duke Eye Center.
My passions are teaching, caring for patients and doctors, and saving retinal ganglion cells.
My research interests include patient education and adherence, medical and surgical education, OCT imaging for glaucoma, and physician wellness.

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