Slammed by long and unpredictable hours, heavy clinical workloads, fatigue and limited professional control, many medical residents experience stress and even burnout. And surveys indicate this burnout can seriously impact physician well-being and patient care outcomes.
How do you combat burnout? Studies show that meditation can improve well-being, but jamming one more thing into a resident's hectic day is tough, as Louise Wen, MD, a clinical instructor at Stanford's Department of Anesthesiology, Perioperative and Pain Medicine, points out. So Wen joined a team of Stanford researchers to test the effectiveness of a mindfulness app, and their work was published this summer in Academic Psychiatry.
I recently spoke with her about the pilot study.
What inspired your study?
I experienced burnout as a resident, and meditation was a key aspect to my recovery. Growing up, I had been introduced to meditation by my family. In college, I trained to become a yoga teacher and therapist. However, once residency started, my mediation practice essentially stopped.
My low point in residency was precipitated by a HIV needle-stick injury. The month-long antiretroviral prophylactic therapy was effective, but I struggled with the medication's side effects. My mother advised me to meditate, and afterwards, I felt like my brain had been rebooted. Surprised by the effect of such a brief intervention, I wanted to explore ways to introduce this technique to other time-strapped and stressed residents
Why did you use a mindfulness app?
The gold standard for mindfulness studies is a Mindfulness Based Stress Reduction course developed by Jon Kabat-Zinn, PhD. This eight-week course entails a two-hour group class weekly and 45 minutes of individual home practice daily, plus one full-day silent retreat. This excellent and evidence-based intervention is unfortunately not a feasible format for residents. Instead, the Headspace app on a smart phone delivers guided meditations in an efficient and accessible format.
For the study, we recruited 43 residents from general surgery, anesthesia and obstetrics and gynecology. They were asked to use the app at least two times per week for a month. The app provided 10-minute guided audio meditations, animated videos and longer focused meditations.
How did you measure whether the app improved wellness?
Our participating residents were asked to complete surveys measuring their stress, mindfulness and app usage -- at enrollment, week two and week four. We found that residents benefitted from using the app and this benefit correlated with increasing app usage.
Are you doing any follow-up studies?
A significant challenge of our app study was motivating people to practice the intervention. We're now working on a study based on the concept of the popular opinion leader. We have developed a four-week, video-based curriculum for anesthesia residents. These videos feature interviews with attendings from our department, where they share their personal meditation and gratitude practices. We showed the videos to the intervention group of residents, whereas the control group watched a boring video of me saying that they should meditate. We are now analyzing the data.
Previously: Countering the problem of physician burnout, Physician-monk leads Stanford doctors in meditation and Research brings meditation's health benefits into focus
Photo courtesy of Louise Wen