8130 Development and Integration of a Modified Mindfulness Curriculum Designed to Optimize Resident Surgical Performance

Abstract

<h3>Study Objective</h3> This project aimed to develop and assess a feasible and meaningful modified Mindfulness-based Cognitive Therapy (MBCT) curriculum for surgical residents. <h3>Design</h3> A mixed methods embedded design was employed to assess feasibility and desirability of the curriculum. Secondary outcomes were measured in a pre- and post- intervention design using validated surveys to assess surgical performance, anxiety, confidence, and burnout. <h3>Setting</h3> Urban Canadian post-graduate training program in obstetrics and gynecology (Obstetrics and Gynecology). <h3>Patients or Participants</h3> Obstetrics and Gynecology residents in post-graduate years two to five were invited to participate. <h3>Interventions</h3> Residents participated in a 12-week modified MBCT curriculum tailored to busy surgical trainees. Focus groups and surveys were completed before, immediately after, and 3 months following completion of the MBCT course. Validated survey tools assessed surgical performance, anxiety, confidence, and burnout. Qualitative components assessed how mindfulness techniques are used in the operating room. <h3>Measurements and Main Results</h3> Twelve out of sixty-one residents enrolled in the program (20%) and eight completed the course (67%). There was a statistically significant decrease in anxiety (p < 0.001) and increase in surgical confidence (p = 0.007) following the MBCT curriculum. There was no change in burnout or surgical evaluations. The major qualitative themes identified that mindfulness tools were regularly incorporated into the operating room and had a perceived beneficial impact by residents. This change was sustained 3 months post intervention. The biggest barrier to mindfulness was time. Participants felt the residency program should support ongoing MBCT training to promote a positive culture shift in the department. <h3>Conclusion</h3> A modified MBCT program for surgical trainees is feasible and desirable for Obstetrics and Gynecology residents and positively impacts anxiety and surgical confidence. Trainees noted a sustained benefit from the course. Future work should focus on expanding this study to other surgical specialties and addressing barriers to mindfulness raised by participants.