Online Training in Mind-Body Therapies: Different Doses, Long-term Outcomes

Abstract

Background.There is a high rate of burnout among health professionals, driving diverse attempts to promote resilience and well-being to counter this trend. The purpose of this project was to assess the dose-response relationship between the number of hours of online mind-body skills training for health professionals and relevant outcomes a year later.Methods.Among 1438 registrants for online training (including up to 12 hours of training on mind-body practices) between December 2013 and November 2015, we analyzed responses from the first 10% who responded to an anonymous online survey between December 1, 2015 and February 1, 2016. Questions included the type and frequency of mind-body practice in the past 30 days and whether the online training had any impact on personal life or professional practice. Standardized measures were used to assess stress, mindfulness, confidence in providing compassionate care, and burnout.Results.The 149 respondents represented a variety of ages and health professions; 55% completed one or more mind-body training modules an average of 14 months previously. Most (78%) engaged in one or more mind-body practices in the 30 days before the survey; 79% reported changes in self-care and 71% reported changes in the care of others as a result of participating. Increasing number of hours of training were significantly associated with practicing mind-body skills more frequently; increasing practice frequency was associated with less stress and burnout, which were associated with missing less work. Greater practice frequency was also associated with improvements in stress, mindfulness, and resilience, which were associated with increased confidence in providing compassionate care.Conclusion.Online training in mind-body therapies is associated with changes in self-reported behavior one year later; increasing doses of training are associated with more frequent practice which is associated with less stress, burnout, and missing work, and higher levels of mindfulness, resilience, and confidence in providing compassionate care. Additional studies are needed to compare mind-body skills training with other interventions designed to improve resilience and compassion while decreasing burnout in health professionals.

Interventions to increase resilience in physicians: A structured literature review

“…In the same study, Kemper and Khirallah (2015b) found that resilience scores did not improve significantly upon completing the module, 'Introduction to stress, resilience and the relaxation response'; however, in a later study, Kemper and Rao (2017a) found that scores improved 'modestly but significantly' for the same module. In another study, Kemper et al (2017b) examined the relationship between the number of hours of online mind-body skills training and outcomes one year later. Kemper et al (2017b) found that the more hours of training participants completed, the more frequently participants practiced mind-body skills one year later.…”

“…The most common study design was a cohort study; all cohort studies in this review were uncontrolled. All but one of the cohort studies (Kemper, Rao, Gascon & Mahan, 2017b) used a pre-post design.…”

“…Kemper and others used a module, 'Introduction to stress, resilience and the relaxation response' to measure for changes in resilience (Kemper & Khirallah, 2015b;Kemper & Rao, 2017a). Kemper et al (2017b) also conducted a one-year follow-up study for health professionals who completed an online module in integrative therapies.…”

“…Researchers used different scales to measure resilience. Studies of online training used Smith's 6-item Brief Resilience Scale, which is a standardized and reliable instrument (Kemper et al, 2015a;Kemper et al, 2017b;Kemper & Khirallah, 2015b).…”

“…Sample sizes ranged from 11 participants for a qualitative study to 1066 respondents to an online survey (Lee et al, 2015;Schneider et al, 2014). For online interventions, sample sizes were between 149 and 513 people, with physicians making up around 20 per cent of samples (Kemper et al, 2017b;Kemper & Khirallah, 2015b;Kemper & Rao, 2017a). Group interventions involved fewer participants, and the proportion of physicians varied.…”