title: Stress and burnout among critical care fellows: preliminary evaluation of an educational intervention.
abstract: BACKGROUND
  Despite a demanding work environment, information on stress and burnout of critical care fellows is limited.
  
  
  OBJECTIVE
  To assess 1) levels of burnout, perceived stress, and quality of life in critical care fellows, and 2) the impact of a brief stress management training on these outcomes.
  
  
  METHODS
  In a tertiary care academic medical center, 58 critical care fellows of varying subspecialties and training levels were surveyed to assess baseline levels of stress and burnout. Twenty-one of the 58 critical care fellows who were in the first year of training at the time of this initial survey participated in a pre-test and 1-year post-test to determine the effects of a brief, 90-min stress management intervention.
  
  
  RESULTS
  Based on responses (n=58) to the abbreviated Maslach Burnout Inventory, reported burnout was significantly lower in Asian fellows (p=0.04) and substantially higher among graduating fellows (versus new and transitioning fellows) (p=0.02). Among the intervention cohort, burnout did not significantly improve--though two-thirds of fellows reported using the interventional techniques to deal with stressful situations. Fellows who participated in the intervention rated the effectiveness of the course as 4 (IQR=3.75-5) using the 5-point Likert scale.
  
  
  CONCLUSIONS
  In comparison with the new and transitioning trainees, burnout was highest among graduating critical care fellows. Although no significant improvements were found in first-year fellows' burnout scores following the single, 90-min training intervention, participants felt the training did provide them with tools to apply during stressful situations.
authors.affiliation: Division of Pulmonary and Critical Care, Department of Medicine, Mayo Clinic, Rochester, MN, USA.|Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, USA; Kashani.kianoush@mayo.edu.
authors.forename: Kianoush
authors.initials: K
authors.lastname: Kashani
authors.affiliation: Division of Pulmonary and Critical Care, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Perliveh
authors.initials: P
authors.lastname: Carrera
authors.affiliation: Division of Pulmonary and Critical Care, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Alice Gallo
authors.initials: AG
authors.lastname: De Moraes
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Amit
authors.initials: A
authors.lastname: Sood
authors.affiliation: Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA.
authors.forename: James A
authors.initials: JA
authors.lastname: Onigkeit
authors.affiliation: Division of Pulmonary and Critical Care, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Kannan
authors.initials: K
authors.lastname: Ramar
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000367:Age Factors; D002055:Burnout, Professional / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D003422:Critical Care / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D011788:Quality of Life; D044469:Racial Groups; D012737:Sex Factors
keywords: burnout; critical care; medical education; mental health; program evaluation; survey research