CA-1 Wellness Intervention Program

Stress-related morbidity among residents and practicing physicians is high. Studies report a much higher level of burnout, depression and other psychiatric morbidities in residents and physicians compared to the general public.

In response to this,  the Department of Anesthesiology in 2006 launched a wellness intervention for Anesthesiology residents. The goal of the program (Coping with Work and Family Stress ™) is to teach residents effective behavioral, social, and cognitive coping strategies to deal with stressors at work and at home.

Effectiveness of the Wellness Intervention

Studies of the effectiveness of the wellness intervention have demonstrated positive effects on reported stressor levels, active and avoidance coping strategies, psychological symptoms and substance use.

The result of our own investigation on the effectiveness of the program found that those in the wellness group, as compared to those in control conditions, reported a reduction in anxiety and work/family stressors; an increase in social support from supervisors and colleagues;  an enhanced use of active coping strategies, such as problem solving and cognitive restructuring; and a decreased use of avoidance coping strategies, such as smoking and alcohol consumption.

We provide the wellness intervention to all CA-1 residents. It consists of 16  one-hour weekly sessions held during work hours. The program curriculum includes didactic presentations, group discussions and stress management and problem solving techniques  specific to residents’ situations. The program consists of four components:

• The first component:  focuses on teaching methods that can potentially eliminate or modify the sources of stress. This part of the curriculum includes training on the identification and analysis of stressful situations and the use of effective problem solving, effective communication, and their social networks.
  
• The second component: teaches techniques to modify cognitive and appraisal processes. These approaches (e.g., cognitive restructuring) are necessary for stressors that cannot be directly modified.
• The third component: emphasizes stress management techniques (e.g., relaxation, exercise) and modalities to minimize the use of avoidance coping (e.g., reinforcing alternatives to the use of alcohol to reduce tension, teaching refusal skills). The stress management techniques are practiced for a few minutes at the beginning of each subsequent session for reinforcement purposes.
  
• The fourth component:  integrates the course material through the creation of the participants’ own personal stress management plans.

Resident health and wellbeing is a top priority of the Yale Anesthesiology Residency Program.  We continue to conduct research to delineate risk factors in medical education and medical practice and resident’s wellbeing. For more information or to become involved in research projects, contact Dr. Haleh Saadat at Haleh.saadat@yale.edu or call (203)785-2802.