S612 Effectiveness of a Mindfulness-Based Intervention in Endoscopy Among Gastroenterology Fellows: A Pilot Study

Abstract

Introduction: Mindfulness training reduces stress and improves performance among surgical trainees. However, such interventions have not been examined for endoscopy among gastroenterologists. In this novel pilot study, we assessed (i) the feasibility of implementing a mindfulness intervention for endoscopy among gastroenterology (GI) fellows (ii) the impact of this intervention on endoscopy-associated stress measures. Methods: We performed a prospective cohort study enrolling GI fellows (n=7) at a tertiary academic medical center, over a 12 week study duration. Participants underwent two 1 hour workshops in Mindfulness Based Stress Reduction (MBSR) taught by a trained mindfulness practitioner at weeks 0 and 8. Participants completed baseline and post-intervention surveys measuring feasibility, stress, and use of mindfulness practice during endoscopy during week 0 and week 12 and, (ii) weekly validated State-Trait Anxiety Inventory (STAI-6) surveys measuring stress during endoscopic sessions from week 8 – week 12. Pre- and post- survey results were reported with mean differences using paired t-tests or Wilcoxon signed-rank tests (p< 0.05); STAI-6 trends were analyzed with linear regression and Pearson’s correlation. Results: All seven GI fellows completed the 12 week study. GI fellows significantly increased the use of mindfulness practice during endoscopy (mean [SD] difference +1.14 [0.18], p< .05) (Figure Panel A, Table). STAI-6 scores significantly decreased following mindfulness intervention over the course of 12 weeks (p < 0.05, r = -0.86) (Figure Panel E), with the largest improvement of stress measures among first-year GI fellows. Conclusion: During this prospective study, we provide novel evidence that a simple mindfulness intervention for endoscopy among GI fellows is feasible, improves uptake of mindfulness during endoscopy, and is associated with stress reduction. Mindfulness practice may prove a valuable technique to reduce stress during endoscopic training for GI fellows.Figure 1.: Panel A: Actual use of mindfulness practice during endoscopy by individual GI fellows as measured using a four point Likert Scale pre (week 0) and post (week 12) mindfulness based intervention. Panel B: Self reported likelihood of using mindfulness practice during endoscopy in the future as measured using a four point Likert Scale pre (week 0) and post (week 12) mindfulness based intervention. Panel C: Perceived feasibility of mindfulness practice during endoscopy as measured using a four point Likert Scale pre (week 0) and post (week 12) mindfulness based intervention. Panel D: STAI-6 scores per participant over time. Panel E: Mean STAI-6 scores across all GI fellows over time. Table 1. - Comparison of Pre and Post-Survey Responses Question Mean Change in Score P-value Uptake of Mindfulness During Endoscopy 1.14 (0.28) < 0.05* Feasibility of Mindfulness During Endoscopy 0.57 (0.98) 0.17 Intention to Use Mindfulness in Future Endoscopic Practice 0.42 (1.39) 0.44 Burnout -0.42 (0.53) 0.23 Positive Learning Environment -0.43 (0.98) 0.29 Enthusiasm -0.29 (0.49) 0.52 Positive Teaching 0.14 (0.90) 0.68 Fulfillment -0.14 (1.07) 0.74 Sense of Accomplishment 0.57 (0.79) 0.12