MedicalResearch.com Interview with:
Carter Lebares, MD
Assistant Professor of Surgery
Director, Center for Mindfulness in Surgery
Department of Surgery, UCSF
MedicalResearch.com: What is the background for this study?
Response: This study was inspired by extensive evidence of the effectiveness of mindfulness-based interventions (MBIs) for mitigating stress and enhancing performance in other high-stress populations like police and the military. We know that overwhelming stress is related to burnout and to cognitive errors – two critical issues within surgery, today. This prompted us to tailor and streamline an MBI specifically for surgeons, and to test it in our trainees.
MedicalResearch.com: What are the main findings?
Response: This was a pilot study, as recommended by the NIH and in line with research in sustainable implementation practices. As such, we primarily tested intervention feasibility and the study methodology in preparation for an adequately-powered multicenter trial of efficacy.
That said, our effect-size findings are really exciting and suggest several promising areas of mindfulness-based interventions’ impact for surgeons. In particular stress, mindfulness, working memory capacity and cognitive control (which includes attention, vigilance and ‘set shifting’, or the ability to focus in a complex environment). These findings reflect statistically significant impacts seen in other high-stress and high performance groups in these same domains. They are highly relevant areas of impact for our profession.
MedicalResearch.com: What should readers take away from your report?
Response: That burnout and healthcare reform for physician well-being are of paramount importance. We know the solution requires interventions on the individual, system and institutional level. In the realm of individuals, a tailored MBI like UCSF’s Enhanced Stress Resilience Training (or ESRT) shows highly promising impact on stress and executive function. The potential to improve our experience, reclaim some joy in what we do, and improve our performance is truly exciting.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: We are preparing the MCT to test our codified curriculum in larger surgeon populations, and have begun testing in other contexts (other academic institutions, non-academic programs, military, trauma, under-resourced settings) to see if these results reach significance and are translatable to other settings.
MedicalResearch.com Is there anything else you would like to add??
Driving motivation is the recognition that judgment and commitment are paramount assets for surgeons, and to continue without dedicated training to optimize our minds is, frankly, crazy.
Lebares CC, Guvva EV, Olaru M, et al. Efficacy of Mindfulness-Based Cognitive Training in Surgery: Additional Analysis of the Mindful Surgeon Pilot Randomized Clinical Trial. JAMA Netw Open. 2019;2(5):e194108. doi:10.1001/jamanetworkopen.2019.4108
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