# The Stress Management and Resiliency Training (SMART) Program Is Associated with Sustained Improvement in Clinician Well-Being: Results from an Observational Cohort Study

## TL;DR

The SMART Program improves clinician well-being and reduces burnout, with benefits lasting six months after completion.

## Contribution

The study shows sustained well-being improvements in clinicians from the SMART Program for at least six months.

## Key findings

- Clinicians showed significant improvements in well-being, burnout, and stress coping after participating in the SMART Program.
- Benefits were maintained six months post-program, with improvements linked to using more stress-management tools and meditation practice.

## Abstract

Public health relevance—How does this work relate to a public health issue?
Clinician burnout remains a widespread public health challenge linked to reduced clinician well-being, reduced quality and safety of patient care, and increased workforce turnover.Evidence-based, multimodal interventions such as the Stress Management and Resiliency Training (SMART) Program offer practical approaches to support clinician well-being.

Clinician burnout remains a widespread public health challenge linked to reduced clinician well-being, reduced quality and safety of patient care, and increased workforce turnover.

Evidence-based, multimodal interventions such as the Stress Management and Resiliency Training (SMART) Program offer practical approaches to support clinician well-being.

Public health significance—Why is this work of significance to public health?
The SMART Program is associated with significant and sustained improvements in clinician well-being, perceived stress, burnout, coping, resilience, and self-compassion for at least six months following program completion.

The SMART Program is associated with significant and sustained improvements in clinician well-being, perceived stress, burnout, coping, resilience, and self-compassion for at least six months following program completion.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Well-being improvements six months following program completion were most strongly associated with the number of stress-management tools being used by participants.Implementation efforts should address structural barriers that limit access for clinicians who may benefit most.

Well-being improvements six months following program completion were most strongly associated with the number of stress-management tools being used by participants.

Implementation efforts should address structural barriers that limit access for clinicians who may benefit most.

Background: Burnout negatively impacts clinicians, patients, and healthcare systems. We examined the immediate and sustained effects of an evidence-based, multi-modal Stress Management and Resiliency Training (SMART) Program on clinician well-being. Methods: Clinicians who registered to participate in the SMART Program were invited to join an observational study and complete questionnaires before the program started, at two months (post-program), and at eight months (six months following program completion). Results: We found significant improvements in well-being, burnout, perceived stress, stress coping, resilience, and self-compassion at 2 months (all p < 0.001), with moderate-to-large effect sizes (d = 0.57 to 1.0). Significant benefits were maintained at 8 months, with small-to-moderate effect sizes (d = 0.41 to 0.65). Exploratory analyses found significant correlations between improvements in well-being from baseline to 8 months and the number of stress-management techniques used at 8 months (r = 0.53, p < 0.0001) and the number of days on which participants practiced meditation for at least 10 min (r = 0.28, p = 0.049). Conclusion: Participation in the SMART Program was associated with significant improvements in clinician well-being that persisted six months following program completion and was positively associated with the number of stress-management tools used and meditation practice.