Enhanced stress-resilience training for surgical trainees
Open accessAbstract
Introduction: Core surgical training programmes are associated with a high risk of burnout. This study aimed to assess the influence of a novel enhanced stress-resilience training (ESRT) course delivered at the start of core surgical training in a single UK statutory education body. Method: All newly appointed core surgical trainees (CSTs) were invited to participate in a 5-week ESRT course teaching mindfulness-based exercises to develop tools to deal with stress at work and burnout. The primary aim was to assess the feasibility of this course; secondary outcomes were to assess degree of burnout measured using Maslach Burnout Inventory (MBI) scoring. Results: Of 43 boot camp attendees, 38 trainees completed questionnaires, with 24 choosing to participate in ESRT (63.2 per cent; male 13, female 11, median age 28 years). Qualitative data reflected challenges delivering ESRT because of arduous and inflexible clinical on-call rotas, time pressures related to academic curriculum demands and the concurrent COVID-19 pandemic (10 of 24 drop-out). Despite these challenges, 22 (91.7 per cent) considered the course valuable and there was unanimous support for programme development. Of the 14 trainees who completed the ESRT course, nine (64.3 per cent) continued to use the techniques in daily clinical work. Burnout was identified in 23 trainees (60.5 per cent) with no evident difference in baseline MBI scores between participants (median 4 (range 0–11) versus 5 (1–11), P = 0.770). High stress states were significantly less likely, and mindfulness significantly higher in the intervention group (P < 0.010); MBI scores were comparable before and after ESRT in the intervention cohort (P = 0.630, median 4 (range 0–11) versus 4 (1–10)). Discussion: Despite arduous emergency COVID rotas ESRT was feasible and, combined with protected time for trainees to engage, deserves further research to determine medium-term efficacy.
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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 [31]
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- Authors
- Luton, O. W., James, O. P., Mellor, K., Eley, C., Hopkins, L., Robinson, D. B. T., Lebares, C. C., Powell, A. G. M. T., Lewis, W. G., & Egan, R. J.
- Affiliations
- Health Education and Improvement Wales’ School of Surgery, Tŷ Dysgu, Cefn Coed , Nantgarw, UK
- University of California, San Francisco (US)
- Cardiff University (GB)
- Swansea Bay University Health Board (GB)
- Corresponding author
- Powell, A G M T
- ORCID
- Venue
- BJS Open
- Publisher
- Oxford University Press (OUP)
- Published
- 2021-07-01
- Volume
- 5
- Issue
- 4
- ISSN
- 2474-9842 (ISSN-L)
- PMC
- PMC8320339
- OpenAlex
- W3184121086
- Cited by
- 44
- References
- 26
- Citations by year
- 2026: 5 · 2025: 11 · 2024: 13 · 2023: 10 · 2022: 4 · 2021: 1
- FWCI
- 7.87
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BJS Open (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (acceptedVersion)
- Funders
- Royal College of Surgeons of England
- Bangor University
- University of California, San Francisco
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- burnout, surgical residents, mindfulness, core surgical training, occupational stress, feasibility, COVID-19 pandemic, Maslach Burnout Inventory
- MeSH terms
- COVID-19, Adult, Anxiety, Burnout, Professional, Curriculum, Depression, Feasibility Studies, Female, United Kingdom, Humans, Male, Surveys and Questionnaires, Stress, Psychological, General Surgery, Work Schedule Tolerance, Resilience, Psychological, Pandemics, Mindfulness, Surgeons
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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