Enhanced Stress Resilience Training for UK Surgical Trainees; Effect and Evolution Evaluated
Open accessAbstract
Core Surgical Training (CST) programs are associated with high burnout. This study aimed to assess the influence of Enhanced Stress Resilience Training (ESRT) over a 2-year period in a single UK Statutory Education Body. CSTs participated in 5-weeks of formal ESRT to address work stressors. The primary outcome measure was career progression related to curriculum metrics and National Training Number (NTN) appointment. Secondary measures related to burnout using validated psychological inventories. Of 42 CSTs, 13 engaged fully with ESRT (31.0%; male 8, female 5, median age 28 year.), 11 engaged partially, and 18 did not. ESRT engagement was associated with better NTN appointment (ESRT 8/13 (61.5%) vs. not 1/18 (5.6%), p = 0.025), less burnout [aMBI; mean 5.14 (SD ± 2.35) vs. 3.14 (±2.25), F 6.637, p = 0.002, ηp2=0.167], less stress [PSS-10; 19.22 (±5.91) vs. 15.79 (±5.47), F 8.740, p < 0.001, ηp2=0.200], but more mindfulness [CAMS-R; 19.22 (±5.91) vs. 20.57 (±2.93), F 3.201, p = 0.047, ηp2=0.084]. On multivariable analysis, Improving Surgical Training (run-through CST) program (OR 5.2 (95% CI 1.42-28.41, p = 0.022), MRCS pass (OR 17.128 (95% CI 1.48-197.11, p = 0.023) and ESRT engagement (OR 13.249, 95% CI 2.08-84.58, p = 0.006) were independently associated with NTN success. ESRT was associated with less stress and burnout, better mindfulness, and most importantly 13-fold better career progression.
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Our findings provide the first evidence of the effectiveness of ESRT in graduate-entry medical students, complimenting findings reported in US- and UK-based surgical trainees.
“Our findings provide the first evidence of the effectiveness of ESRT in graduate-entry medical students, complimenting findings reported in US- and UK-based surgical trainees [23, 30–32].”
From Enhanced Stress-Resilience Training (ESRT) for graduate-entry medical students: a randomised-controlled, mixed-method investigation (2025) · cites this paper as [32]
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- Authors
- Luton, O. W., James, O. P., Mellor, K., Eley, C., Hopkins, L., Robinson, D. B. T., Barlow, E., Lebares, C. C., Lewis, W. G., & Egan, R. J.
- Affiliations
- National Health Service Wales (GB)
- University of California, San Francisco (US)
- University Hospital of Wales (GB)
- Swansea Bay University Health Board (GB)
- Corresponding author
- James, Osian P.
- ORCID
- Venue
- Journal of Surgical Education
- Publisher
- Elsevier BV
- Published
- 2023-10
- Volume
- 80
- Issue
- 10
- Pages
- 1395-1402
- ISSN
- 1878-7452 (ISSN-L)
- 1931-7204
- OpenAlex
- W4385693274
- Cited by
- 13
- References
- 18
- Citations by year
- 2026: 2 · 2025: 10 · 2024: 1
- FWCI
- 4.58
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of surgical education (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
- Funders
- Bangor University
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Keywords
- surgical residents, core surgical training, burnout, occupational stress, mindfulness, career development, occupational stressors, psychological well-being, Royal College of Surgeons of England, Royal College of Surgeons
- MeSH terms
- Occupational Stress, Adult, Burnout, Professional, Curriculum, Education, Medical, Graduate, Female, United Kingdom, Humans, Internship and Residency, Male, Stress, Psychological, General Surgery, Resilience, Psychological
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