Trainees in pediatric medical residencies face a high level of occupational demand. Between 39-75% of residents report occupational burnout. This is experienced as emotional exhaustion, impaired work performance, and decreased empathy for patients. Mindfulness training might prevent burnout through its focus on stress management and empathy; however, it requires extra time which overburdened residents lack.
Fraiman et al. [JAMA Pediatrics] developed a mindfulness-based training that could be practically integrated into pediatric residencies and tested whether it could help prevent emotional exhaustion and burnout.
The researchers recruited 15 pediatric medical residency programs that included a total of 365 eligible pediatric residents to participate in the study. Programs were randomly assigned to the mindfulness training or control arm after pairing them on location and size. Six residents declined participation, leading to an initial sample of 359 participants (75% female).
The mindfulness program included 1-hour monthly meetings for the first 7 months of the program. Residents were encouraged but not required to attend, and attendance was not taken. Each monthly meeting began with a social lunch followed by a minute of silence, introductory remarks, a mindfulness exercise, and a subsequent debriefing.
Mindfulness exercises were designed to be ones residents could integrate into their busy days and be relevant to their work. Two weeks after each meeting, residents were invited to utilize a 10-minute pre-recorded guided body scan.
The control arm of the study involved 7 one-hour social lunches without instruction. Residents in both arms were assessed at baseline, 6 months, and 15 months on self-report measures of emotional exhaustion (study primary outcome), depersonalization, empathy, personal accomplishment, burnout, perspective taking, and mindfulness (Five Facet Mindfulness Questionnaire).
Participant dropout rates from the study follow up were 20% at 6 months and 43% at 15 months, and were roughly equal across groups
The results showed no difference between the mindfulness and socializing groups over time on emotional exhaustion, burnout, empathy, perspective taking, or mindfulness. Most residents reported burnout at baseline (75% in the mindfulness group and 60% in the control arm) and burnout increased over time in each group.
By month 15, 84% of the mindfulness group and 88% of the control group reported burnout. Self-reported frequency in use of mindfulness practices did not differ by group, indicating both groups used mindfulness to a similar degree.
The study showed a low-dose, once per monthly mindfulness intervention adapted to the occupational needs of pediatric residents did not outperform a time-matched socializing group on reducing emotional exhaustion and burnout.
Resident burnout rates at baseline were much higher than those reported in prior studies. The adapted program used in this study was much less intensive than most mindfulness programs, not taught by trained mindfulness teachers, and no records were kept of attendance or home practice.
Fraiman, Y. S., Cheston, C. C., Cabral, H. J.,... Sox, C. M. (2022). Effect of a Novel Mindfulness Curriculum on Burnout During Pediatric Internship: A Cluster Randomized Clinical Trial. JAMA Pediatrics.
Link to study