Impact of Mindfulness-Based Attention Training on Fellows' Attention, Stress, and Well-Being

Introduction: Physicians-in-training experience significant cognitive demand as they juggle mastering clinical knowledge, communicating with families and staff, and learning new skills. Traditional medical training often lacks validated structured training on attentional awareness and management of cognitive demand. Our study explored the feasibility of delivering a validated mindfulness-based attention training (MBAT) to pediatric intensive care (PICU) fellows at a quaternary care academic center and its impact on their attention, stress, and well-being.


Methods: Eight pediatric critical care fellows underwent the 8-hour, 4-week MBAT course. Before and after the training, participants completed the Sustained Attention to Response Task (SART), and various questionnaires including the positive and negative affect schedule (positive affect only), the perceived stress scale, the burnout assessment tool, and a questionnaire on anxiety and depression (Patient Health Questionnaire-4). Paired sample t-tests were used to compare raw scores prior to and after the training. The participants also completed a post-survey with open and closed-ended questions on attendance, obstacles to attendance, and home-based practice.


Results: 87.5% of participants attended all 4 sessions. Compared to the pre-training scores, post-training scores showed a significant increase in positive affect (t=2.73, p=0.027, d=.98), decrease in burnout (t=2.55, p=.038, d=-.90), and decrease in perceived stress (t=2.79, p=.0268, d=-.99). No significant changes in the patient health questionnaire (t=.89, p=.40) or the SART task for omission, commission, and reaction time were found (p= 0.57, p=0.7, p=0.12). Responses to open-ended questions showed that the fellows had difficulty integrating mindfulness practice outside of work because of perceived lack of time and failure to remember to practice.


Conclusions: Though a small sample size, these results suggest MBAT is feasible for physician undergoing training, and has the potential to increase positive affect, decrease burnout, and decrease perceived stress. Future work should focus on testing MBAT in a larger sample of medical trainees and how we can facilitate integration of practice outside of work.