A significant proportion of physicians and medical trainees experience stress-related anxiety and burnout resulting in increased absenteeism and disability, decreased patient satisfaction, and increased rates of medical errors. A review and meta-analysis was conducted to examine the effectiveness of interventions aimed at addressing stress, anxiety, and burnout in physicians and medical trainees. Twelve studies involving 1034 participants were included in three meta-analyses. Cognitive, behavioral, and mindfulness interventions were associated with decreased symptoms of anxiety in physicians (standard differences in means [SDM], -1.07; 95% confidence interval [CI], -1.39 to -0.74) and medical students (SDM, -0.55; 95% CI, -0.74 to -0.36). Interventions incorporating psychoeducation, interpersonal communication, and mindfulness meditation were associated with decreased burnout in physicians (SDM, -0.38; 95% CI, -0.49 to -0.26). Results from this review and meta-analysis provide support that cognitive, behavioral, and mindfulness-based approaches are effective in reducing stress in medical students and practicing physicians. There is emerging evidence that these models may also contribute to lower levels of burnout in physicians.

With the current shift to include positive outcomes of trauma, this research was designed to explore factors that allow growth to occur. Structural equation modeling was used to test a model for understanding posttraumatic growth. A sample (N = 174) of bereaved HIV/AIDS caregivers completed questionnaires. Spirituality, social support, and stressors were found to have a positive relationship with growth. Facilitation of posttraumatic growth is crucial to all helping professions.

Objectives: Substantial research demonstrates that the stressors accompanying the profession of paramedicine can lead to mental health concerns. In contrast, little is known about the effects of stress on paramedics’ ability to care for patients during stressful events. In this study, we examined paramedics’ acute stress responses and performance during simulated high-stress scenarios.Methods: Twenty-two advanced care paramedics participated in simulated low-stress and high-stress clinical scenarios. The paramedics provided salivary cortisol samples and completed an anxiety questionnaire at baseline and following each scenario. Clinical performance was videotaped and scored on a checklist of specific actions and a global rating of performance. The paramedics also completed patient care documentation following each scenario.Results: The paramedics demonstrated greater increases in anxiety (P < .05) and salivary cortisol levels (P < .05) in response to the high-stress scenario compared to the low-stress scenario. Global rating scores were significantly lower in the high-stress scenario than in the low-stress scenario (P < .05). Checklist scores were not significantly different between the two scenarios (P = .12). There were more errors of commission (reporting information not present in the scenario) in the patient care documentation following the high-stress scenario than following the low-stress scenario (P < .05). In contrast, there were no differences in omission errors (failing to recall information present in the scenario) between the two scenarios (P = .34).Conclusion: Clinical performance and documentation appear vulnerable to the impact of acute stress. This highlights the importance of developing systems and training interventions aimed at supporting and preparing emergency workers who face acute stressors as part of their every day work responsibilities.LeBlanc VR, Regehr C, Tavares W, Scott AK, MacDonald R, King K. The impact of stress on paramedic performance during simulated critical events. Prehosp Disaster Med. 2012;27(4):1-6.