Evaluation of a Mind-body Education Program to Enhance Resiliency and Reduce Burnout in Residents

Study Overview
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Brief Summary
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This prospective, waitlist-control study is evaluating the benefits of a stress management and resiliency training program for residents (SMART-R). The primary aim of this study is to determine whether the SMART-R is effective at increasing coping skills and reducing stress among residents, reflected by changes in constructs such as emotional growth, perceived stress, optimism, and coping styles. Objective parameters (heart rate, galvanized skin response, sleep duration and quality, exercise and actigraphy) measured with the Basis health tracking device will help correlate objective signs to subjective report of stress.

Detailed Description
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The investigators adapted the Benson-Henry Institute Stress Management and Resiliency Training Program -- Relaxation Response Resiliency Program (SMART-3RP) to create the SMART-R resident wellness curriculum. The actual SMART-3RP is both a clinical program and research intervention. The three prongs of the SMART-R include 1) elicitation of the relaxation response through mind-body techniques 2) reducing overall stress reactivity and 3) increasing connectedness to self and others. In a waitlist-control design, the SMART-R was implemented into multiple residents programs at Mass General Hospital, NYU Langone Medical Center, and Weill Cornell Medical College. The primary aim is to evaluate the effectiveness of the SMART-R in increasing coping skills and reducing stress among residents in the participating programs. Participants enrolled will be invited to complete 1) a brief questionnaire before, during (q3months) and after participation in the program (5 questionnaires total). The investigators will also collect continuous physiologic data using the Basis Peak Health Tracking device to correlate the physiologic data with self-report measures of stress. Additionally, objective indicators of daily workload (page frequency, and quantity of notes authored by a resident during a given period) will help control for residents' schedules and busyness, in evaluating perceived stress, wellbeing and other outcomes.

Official Title
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Evaluation of a Mind-body Education Program to Enhance Resiliency and Reduce Burnout in Residents

Conditions
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Resident Burnout

Intervention / Treatment
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* Behavioral: Stress Management and Resiliency Training for Residents (SMART-R)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Residents in the following participating departments: departments of psychiatry, pediatrics, or neurology at MGH, medicine or psychiatry at NYU, or medicine or psychiatry at Cornell Exclusion Criteria: Not a resident in the participating departments

Ages Eligible for Study
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Minimum Age: 21 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Non-Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br>Stress Management and Resiliency Training for Residents (SMART-R) | Behavioral: Stress Management and Resiliency Training for Residents (SMART-R)<br>* The Stress Management and Resiliency Training Program for residents (SMART-R) is a six-hour intervention delivered over 2 or 3 sessions that teaches residents mind-body skills to reduce stress and enhance coping strategies.<br>|
| Active Comparator: Waitlist Control<br>The control group will receive the same intervention (SMART-R) after the experimental group. | Behavioral: Stress Management and Resiliency Training for Residents (SMART-R)<br>* The Stress Management and Resiliency Training Program for residents (SMART-R) is a six-hour intervention delivered over 2 or 3 sessions that teaches residents mind-body skills to reduce stress and enhance coping strategies.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in burnout levels post intervention | Maslach Burnout Inventory (MBI), a validated 22-item self-report measure of professional burnout in human services. The MBI consists of 3 subscales of burnout: emotional exhaustion, depersonalization, and low sense of personal accomplishment. | change between baseline (July 2015), midpoint (week 25), to post intervention (week 52) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in perceived stress post intervention | Perceived Stress Scale (PSS-10) | change between baseline (July 2015), midpoint (week 25), to post intervention (week 52) | 
| Change in continuous physiologic data throughout intervention | Basis Peak Health Tracking device collects continuous physiologic data (heart rate, galvanized skin response, sleep duration and quality, exercise and actigraphy) | change between baseline (July 2015), midpoint (week 25), to post intervention (week 52) | 
| change in mindfulness post intervention | Cognitive and Affective Mindfulness Scale-Revised (CAMS-R) | change between baseline (July 2015), midpoint (week 25), to post intervention (week 52) |