Assessing a Structured Mental Fitness Program for Academic Acute Care Surgeons: A Pilot Study

• Published in: The Journal of surgical research 2024-03, Vol.295, p.9-18
• Main Authors: Bhat, Sneha G., Nagaraj, Madhuri, Balentine, Courtney, Hogan, Timothy, Meier, Jennie, Prince, Hillary, Abdelfattah, Kareem, Zeh, Herbert, Levi, Benjamin
• Format: Article
• Language: English
• Subjects: Academic surgeon; Burnout mitigation; Female; Humans; Internship and Residency; Male; Mental fitness; Mental Health; Pilot Projects; Positive intelligence; Prospective Studies; Surgeons; Wellness
• ISSN: 0022-4804; 1095-8673; 1095-8673
• DOI: 10.1016/j.jss.2023.09.052

There is a well-established positive correlation between improved physician wellness and patient care outcomes. Mental fitness is a component of wellness that is understudied in academic medicine. We piloted a structured mental fitness Positive Intelligence (PQ) training program for academic surgeons, hypothesizing this would be associated with improvements in PQ scores, wellness, sleep, and trainee evaluations. This is a single-institution, prospective, mixed-methods pilot study. All active Burn/Trauma/Acute & Critical Care Surgical faculty and fellows in our division were offered the PQ program and the option to participate in this research study. The 6-wk program consists of daily exercises on a smartphone application, weekly readings, and small-group meetings with a trained mindfulness coach. Study outcomes included changes in pretraining versus post-training PQ scores, sleep hygiene, wellness, and teaching scores. A Net Promoter Score was calculated to measure user overall experience (range −100 to 100; positive scores being supportive). For secondary analysis, participants were stratified into high versus low user groups by “muscle” scores, which were calculated by program use over time. A postintervention focus group was also held to evaluate perceptions of wellness and experience with the PQ program. Data were analyzed for 15 participants who provided consent. The participants were primarily White (73.3%), Assistant Professors (66.7%) with Surgical Critical Care fellowship training (86.7%), and a slight female predominance (53.3%). Comparison of scores pretraining versus post-training demonstrated statistically significant increases in PQ (59 versus 65, P = 0.004), but no significant differences for sleep (24.0 versus 29.0, P = 0.33) or well-being (89.0 versus 94.0, P = 0.10). Additionally, there was no significant difference in teaching evaluations for both residents (9.1 versus 9.3, P = 0.33) and medical students (8.3 versus 8.5, P = 0.77). High versus low user groups were defined by the median muscle score (166 [Interquartile range 95.5-298.5]). High users demonstrated a statistically higher proportion of ongoing usage (75% versus 14%, P