Importance Among surgical trainees, burnout and distress are prevalent, but mindfulness has been shown to decrease the risk of depression, suicidal ideation, burnout, and overwhelming stress. In other high-stress populations, formal mindfulness training has been shown to improve mental health, yet this approach has not been tried in surgery.

Objective To test the feasibility and acceptability of modified Mindfulness-Based Stress Reduction (MBSR) training during surgical residency.

Design, Setting, and Participants A pilot randomized clinical trial of modified MBSR vs an active control was conducted with 21 surgical interns in a residency training program at a tertiary academic medical center, from April 30, 2016, to December 2017.

Interventions Weekly 2-hour, modified MBSR classes and 20 minutes of suggested daily home practice over an 8-week period.

Main Outcomes and Measures Feasibility was assessed along 6 domains (demand, implementation, practicality, acceptability, adaptation, and integration), using focus groups, interviews, surveys, attendance, daily practice time, and subjective self-report of experience.

Results Of the 21 residents included in the analysis, 13 were men (62%). Mean (SD [range]) age of the intervention group was 29.0 (2.4 [24-31]) years, and the mean (SD [range]) age of the control group was 27.4 (2.1 [27-33]) years. Formal stress-resilience training was feasible through cultivation of stakeholder support. Modified MBSR was acceptable as evidenced by no attrition; high attendance (12 of 96 absences [13%] in the intervention group and 11 of 72 absences [15%] in the control group); no significant difference in days per week practiced between groups; similar mean (SD) daily practice time between groups with significant differences only in week 1 (control, 28.15 [12.55] minutes; intervention, 15.47 [4.06] minutes; P = .02), week 2 (control, 23.89 [12.93] minutes; intervention, 12.61 [6.06] minutes; P = .03), and week 4 (control, 26.26 [13.12] minutes; intervention, 15.36 [6.13] minutes; P = .04); course satisfaction (based on interviews and focus group feedback); and posttraining-perceived credibility (control, 18.00 [4.24]; intervention, 20.00 [6.55]; P = .03). Mindfulness skills were integrated into personal and professional settings and the independent practice of mindfulness skills continued over 12 months of follow-up (mean days [SD] per week formal practice, 3 [1.0]).

Conclusions and Relevance Formal MBSR training is feasible and acceptable to surgical interns at a tertiary academic center. Interns found the concepts and skills useful both personally and professionally and participation had no detrimental effect on their surgical training or patient care.

Trial Registration ClinicalTrials.gov identifier: NCT03141190

重要性 在手术学员，倦怠而苦恼很普遍，但正念已经显示出减少抑郁症，自杀意念，倦怠，和难以抗拒的压力的风险。在其他高压力人群中，正式的正念训练已显示可改善心理健康，但尚未在外科手术中尝试过这种方法。

目的 探讨在住院期间进行改良的正念为基础的压力减轻（MBSR）训练的可行性和可接受性。

设计，设置和参与者 自2016年4月30日至2017年12月，在高等学术医学中心的住院医师培训计划中，由21名外科实习生进行了改良MBSR与主动对照的随机临床试验。

干预 每周2小时，修改MBSR班级，并建议在8周内进行20分钟的每日家庭实践。

主要成果和措施 使用焦点小组，访谈，调查，出勤，每日练习时间和主观自我报告，从6个领域（需求，实施，实用性，可接受性，适应性和整合性）评估了可行性。

结果 分析的21位居民中，有13位是男性（62％）。干预组的平均年龄（SD [范围]）为29.0（2.4 [24-31]）岁，对照组的平均（SD [范围]）年龄为27.4（2.1 [27-33]）岁。通过培养利益相关者的支持，正式的抗压力训练是可行的。改进的MBSR是可以接受的，没有磨损。出勤率高（干预组96例中12人缺席[13％]，对照组中72例中11人缺席[15％]）；两组之间每周练习的天数没有显着差异；组之间相似的平均（SD）每日练习时间，仅在第1周时有显着差异（对照组为28.15 [12.55]分钟；干预为15.47 [4.06]分钟；P = .02），第2周（对照组，23.89 [12.93]分钟；干预，12.61 [6.06]分钟；P  = .03），第4周（对照组，26.26 [13.12]分钟；干预，15.36 [6.13]分钟；P  = .04）；课程满意度（基于访谈和焦点小组的反馈）；和培训后感知的可信度（对照，18.00 [4.24]；干预，20.00 [6.55]；P  = .03）。正念技能已整合到个人和专业环境中，并且在12个月的随访中继续进行独立的正念技能练习（每周正式练习的平均天数[SD]，3 [1.0]）。

结论与相关性 正式的MBSR培训是可行的，并且是三级学术中心外科实习生可以接受的。实习生发现这些概念和技能对个人和专业都有用，参与对他们的外科手术训练或患者护理没有不利影响。

试验注册 ClinicalTrials.gov标识符：NCT03141190