This pilot study indicated that a short specific stress management training program for emergency physicians, called the SMART-EM program, is reasonable; however, in our study, the intervention had no statistically significant effects on reducing stress, increasing quality of life, or, to some extent, increasing resilience. The short time span of this specific training mode is an acceptable concept for an intervention for physicians with less time available outside their clinical activity in the emergency department.
Stress management is crucial for the well-being of emergency physicians, who face increasing distress, with burnout rates reaching alarming levels globally [7, 29–31]. Excessive stress not only jeopardizes mental health but also compromises the quality of patient care [32–37]. Resilience is also compromised by the repetitive occurrence of high stress [38, 39]. Burnout is estimated to affect 25 to 60% of physicians and is increasingly recognized as a problem affecting physicians in the workplace [40]. This pilot study investigated feasibility and reliability of a brief stress management training program, the SMART-EM program, tailored for emergency physicians, given their limited availability due to constrained working schedules. While the study revealed the acceptability and practicability of the SMART-EM program, it did not show a significant influence on stress reduction, quality of life, or resilience [1].
Emergency physicians, who experience higher burnout rates than their counterparts, require effective coping tools[41, 42]. Traditional methods, such as physical exercise, travel, hobbies, and mindfulness, have been indicated to be insufficient, necessitating innovative interventions [43, 44]. The SMART-EM program adds a unique dimension by addressing burnout specifically in emergency physicians [13]. This study underscores the need for tailored interventions in this high-stress medical field, emphasizing the potential of the SMART-EM program as an effective intervention [45].
Physician burnout not only affects personal well-being but also has a potential negative impact on patient care quality. The consequences are an increased risk of medical errors, a stressful workplace, and low patient satisfaction [46–48]. In addition to the risks of problems mentioned above, addressing burnout is crucial, and the SMART-EM program has emerged as a viable option for intervention among emergency physicians with busy work schedules [48].
Various coping tools, including physical exercise, travel, hobbies, and mindfulness, have been extensively researched. However, emergency physicians continue to struggle with burnout symptoms in their work [43, 44]. Individuals who resort to unhealthy, poor coping strategies, such as alcohol and drug abuse, avoidance, aggression, and eating disorders, are at a higher risk of burnout and job loss [49, 50].
Several stress reduction programmes for medical students, nurses, and surgeons have shown positive effects, but their applicability for emergency physicians is limited. The SMART-EM program, a short, single-session program, provides a feasible and effective alternative for this specific medical specialty [10, 11]. We also performed an analysis controlling for the confounding factor sex; however, no significant differences were detected between the intervention group and the nonintervention group. This was likely due to the small sample size. Unlike some interventions with small effect sizes and extensive training requirements, the SMART-EM program offers a practical solution within a short time span [12, 13].
While a previous SMART-EM study of radiologists focused on stress reduction, anxiety, and quality of life, this pilot study explored the specific effects of burnout, adding additional dimensions regarding its feasibility and reliability [12]. The results indicate that the SMART-EM program can be an effective coping tool for emergency physicians, reducing stress and improving well-being in this high-stakes medical environment [13].
This pilot study highlights the possibility of implementing the SMART-EM program, a brief stress management program, within the busy schedules of emergency physicians. While the study did not show a significant effect on stress reduction, quality of life, or resilience, the SMART-EM program represents a promising avenue for addressing burnout specifically in emergency physicians. Further research and refinement of the program may enhance its effectiveness and contribute to the well-being of emergency physicians, ultimately improving the quality of patient care in this critical medical field [45].
Limitations
This study had a small sample size, with selection bias due to the possible recruitment of more interested physicians and partially finished surveys at follow-up. The use of a non-intervention group for comparison prevents us from excluding the probability that the effectiveness of the intervention was determined by the attention given by physicians in the SMART-EM group. The limited research burden of the intervention for the participants leads to this less obvious phenomenon and favours the use of this method and greater availability. Moreover, this study was directed towards emergency physicians in a demanding work environment, and generalization of the results to emergency physicians in all academic settings or in non-academic hospitals is not possible. The tool to be useful needs to be applicable in all hospital emergency setting, so it is of real importance to extend further studies including academic and non-academic settings because the professionals working in non-academic emergency departments maybe even more exposed to the risk of stress and burnout.