ORIGINAL ARTICLE

Impact of a Mindfulness-Based, Workplace Group Yoga

Intervention on Burnout, Self-Care, and Compassion in Health
Care Professionals
A Pilot Study
Samuel Ofei-Dodoo, PhD, MPA, MA, Anna Cleland-Leighton, MD, Kari Nilsen, PhD,
Jacob L. Cloward, DO, and Eastin Casey, MD

36% of nonclinical workers reported at least one manifestation of

Objective: To investigate whether a workplace, group mindfulness-based
professional burnout.1,4,5,7 Physician burnout costs the healthcare
yoga intervention could help manage burnout and improve wellbeing among
industry nearly $4.6 billion annually in the United States.12
health care professionals. Methods: A total of 43 health care professionals
Burnout among health care professionals has been associated
participated in 8-week supervised workplace, group mindfulness-based yoga
with many negative sequelae including decreased quality of
activities. The authors used a single-sample, pre-post design. At two points in
patient care. Individuals with high burnout scores are at increased
time (baseline and postintervention), participants completed a set of online
risk of job dissatisfaction, problems in work-life balance, plans
measures assessing burnout, depression, anxiety, stress, resilience, and
to leave the profession or early retirement and alcohol and/or sub-
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compassion. The authors used linear mixed model analysis to assess changes
stance abuse.1,13–19 A study indicates that individuals at risk of
in outcome measures. Results: Participants had improvements after the 8-
burnout rarely self-identify and remain undetected in the workplace.20
week intervention. At postintervention, they had significantly better scores
Several factors complicate the identification of current or
on personal accomplishment, depression, anxiety, stress, perceived resil-
potential risk of burnout in oneself or others. These factors include
ience, and compassion. Participants had a positive perception of the yoga
inadequate knowledge of risk factors and warning signs; diffusion of
intervention. Conclusion: Group mindfulness-based yoga program may be
responsibility (a sense that someone else will address the problem);
convenient and low-cost approach to support health and wellbeing among
discomfort in addressing the issue with colleagues; resistance to
health care professionals.
acknowledging the situation; concern that identifying as ‘‘burned
Keywords: burnout, compassion, health care professionals, medical out’’ has negative consequences; and lack of knowledge of appropri-
education, mindfulness, resilience, yoga ate resources.20
Systematic reviews and meta-analyses conclude that organiza-
tional interventions can help enhance coping skills and mitigate work-
T he medical literature reports disturbingly high rates of burnout
among clinicians,1–3 medical trainees,4–7 and other health care
workers like program coordinators.8,9 These high rates have been
related distress and burnout among health care professionals.21,22 These
interventions share the goals of educating individuals to develop
principally attributed to chronic job stressors.6,10 Manifestations of psychological, emotional, and physical strategies to alleviate stress
burnout are characterized in: overwhelming exhaustion, depersonali- by providing tools for self-care. Programs described in the literature
zation and detachment from the job, and a sense of ineffectiveness and include the practice of mindfulness, a group of self-directed techniques
reduced personal accomplishment.11 As explained by Maslach and that relaxes the body and calms the mind through focusing on present-
Leiter,6 emotional exhaustion refers to a state of mental fatigue. A moment awareness; yoga exercises that can reduce anxiety levels,
worker experiencing emotional exhaustion feels overextended and has improve exhaustion symptoms, and improve physical wellbeing; and
surpassed their coping limits. Depersonalization manifests as cyni- group discussions where individuals share experiences, connect with
cism, emotional detachment, and disengagement. Finally, decreased one another, enhance collegiality, and provide mutual support21,23–25
personal accomplishment refers to a decreased sense of pride in one’s Practices that focused on the connection between mind and body have
work. There is a loss of productivity, efficiency, and decreased feelings shown to be effective strategy to manage stress and build emotional
of competence towards one’s work. As many as 50% of practicing resilience among health care professionals.22,26–28
physician, 51% of resident physicians, 48% of medical students, and We utilized a mindfulness-based yoga intervention in this
study because it is low cost and has shown to be an effective
approach to promote self-care and prevent burnout among nurses.29
From the Wichita Department of Family and Community Medicine (Dr Ofei- The mindfulness-based yoga activities were particularly suitable for
Dodoo, Dr Nilsen); and Wichita Family Medicine Residency Program at
Wesley Medical Center (Dr Cleland-Leighton, Dr Cloward, Dr Casey), the participants in achieving the study outcome given that they were
University of Kansas School of Medicine, Wichita, Kansas. nonreligious, provided meaning and purpose, had both secular and
Clinical significance: Burnout among health care professionals is associated with academic appeal, and previously have been found to work with
many negative sequelae including decreased quality of patient care. This health care professionals.27,30,31
study was conducted as a first step to investigate whether a group, workplace
mindfulness-based yoga intervention could help manage burnout and We studied the impact of a pragmatic workplace supportive
improve wellbeing among health care professionals. intervention (1-hour mindfulness-based yoga activities for 8 weeks)
Funding: This project was funded by the University of Kansas School of on burnout, depression, anxiety, stress, resilience, and compassion
Medicine-Wichita Office of Research with funds from the Wichita Center among health care professionals at the University of Kansas
for Graduate Medical Education.
Conflict of Interest: The authors report no conflicting and competing Interests. School of Medicine-Wichita (KUSM-W). Study participants
Address correspondence to: Samuel Ofei-Dodoo, PhD, MPA, MA, Department of included clinicians, medical trainees, and nonclinical staff
Family and Community Medicine, University of Kansas School of Medicine- members. We hypothesized that participants would have improved
Wichita, 1010 N, Wichita, KS 67214 ([email protected]). scores on validated measures of burnout, depression, anxiety,
Copyright ß 2020 American College of Occupational and Environmental
Medicine stress, resilience, and compassion upon completion of the 8-week
DOI: 10.1097/JOM.0000000000001892 intervention.

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 Ofei-Dodoo et al JOEM  Volume 62, Number 8, August 2020

METHODS TABLE 1. Participants’ Characteristics at Baseline (N ¼ 43)

Study Design and Participants Characteristics All Participants
This study utilized a single-sample, nonexperimental design
comparing pre- and post-intervention scores on validated outcome Gender, no. (%)
measures. We recruited 43 health care professionals associated with Male 6 (14.0)
KUSM-W, a 4-year community-based medical school. The recruit- Female 37 (86.0)
ment utilized E-mail invitations, flyers, and word of mouth. The Age
Mean (SD), y 36.8 (11.2)
inclusion criteria were willingness to complete at least 1 hour of a Minimum 24
mindfulness-based yoga activity weekly, and to complete 25-minute Maximum 64
online surveys (baseline and postintervention). The study coordinator Career status, no. (%)
conducted in-person screening interviews with those who expressed Faculty 11 (25.6)
interest in the project to ensure volunteers were medically fit to Staff 18 (41.9)
participate in the yoga activities. Those eligible were enrolled upon Medical trainees 14 (32.6)
receipt of a signed consent form. A sample size of 34 was calculated First-year residents 1 (7.1)
as necessary for adequate power (more than 0.80) to detect significant Second-year residents 5 (35.7)
group differences among the variables with 0.05 effect size and Third-year residents 5 (35.7)
First-year medical student 0 (0)
P < 0.05.32 No incentive beyond the free yoga sessions was Second-year medical student 3 (21.4)
provided to the participants. The KUSM-W Institutional Review Third-year medical student 0 (0)
Board approved the study protocol for human subject research. Fourth-year medical students 0 (0)
Specialty of clinicians, no. (%) (n ¼ 23)
Intervention Family Medicine 21 (91.3)
The study intervention was workplace, group mindfulness- Obstetrics/Gynecology 1 (4.3)
based yoga sessions led by an experienced yoga instructor (E-RYT Psychiatry 1 (4.3)
200) who has been certified through the Yoga Alliance, ‘‘an Year in clinical practice
organization that sets standards for yoga professionals and teacher Mean (SD), y 8.1 (9.9)
Minimum 1
training programs around the world.’’ The instructor utilized a Maximum 25
combination of Vinyasa flow yoga and Yin yoga practices during Percentage of work time in clinical practice (n ¼ 23)
each session. The sessions were conducted in a calming and <50% 8 (34.8)
comfortable environment that was free of distractions with dim 50% 4 (17.4)
lighting. The initial session consisted of a 30-minute introduction to 51–99% 5 (21.7)
the goals and requirements of the study, plus general information on 100% 4 (17.4)
the principles and practices of yoga. This was followed by Missingy 2 (8.7)
30 minutes of yoga instruction, focusing on breathing awareness 
Employees who did not hold ‘‘faculty’’ appointment to include department
and adapting to the exercises. The subsequent sessions included directors, office managers and staff, program coordinators, IT technicians, etc.
group discussions, mindfulness activities, and yoga practices.33 The y
The number of participants who completed the survey but did not provide an
yoga activities consisted of 1-hour weekly sessions that occurred answer to this specific question.
over 8 weeks. Participants were encouraged to practice additional
mindfulness-based yoga using yoga apps of their choice.
among health care professionals, including physicians, medical
Survey Procedures trainees, and nonclinical professionals.1,4,5,7,34,35 The inventory
Participants completed two assessment surveys during the assesses professional burnout across three dimensions: emotional
study: at baseline and at the end of the 8-week intervention period. exhaustion, depersonalization, and perception of personal accom-
For each assessment, the study questionnaire was hosted in Sur- plishment. Participants recorded their feelings for each item on a 7-
veyMonkey1 (SVMK Inc., San Mateo, CA), a secure web-based point rating scale (0 ¼ never, 6 ¼ every day). Scores for the three
survey system, and a generated link was sent via e-mail to all the questions specific to each of the dimensions were summed with a
participants. The authors sent link of the baseline survey to partic- possible score ranging from zero to 18. We conceptualized burnout
ipants after each had signed the informed consent. We emailed the as a continuous variable along a spectrum ranging from low to high
link for the postintervention survey to all the participants immedi- experienced feelings. For the emotional exhaustion and deperson-
ately after the last group mindfulness-based yoga session. The alization dimensions, higher scores are indicative of greater emo-
authors sent out two reminder e-mails following each survey. tional exhaustion and depersonalization, and greater burnout. For
the personal accomplishment dimension, higher scores indicate a
Study Instruments greater sense of personal accomplishment, and less burnout.
Each survey consisted of the same four validated measures: the
abbreviated Maslach Burnout Inventory (MBI-9); the Depression Depression, Anxiety, Stress, and Resilience
Anxiety Stress Scales-21 (DASS-21); the 14-item Resilience Scale The DASS-21 and RS-14 are validated research tools that
(RS-14); and the Santa Clara Brief Compassion Scale (SCBC). The have been used widely to assess quality of life. The DASS-21con-
baseline survey also included demographic questions such as age, sex, sists of 21 questions in three scales designed to measure negative
and profession (Table 1). The postintervention survey included a emotional states of depression, anxiety, and stress.36,37 These scales
request for feedback on the activities and the number of yoga activities have been found to have high internal consistency and can be used in
each participant engaged in during the 8-week period. a variety of settings to measure current state or changes over time.38
Participants recorded how much a statement applied to them over
Burnout the past week on a 4-point Likert scale (0 ¼ never, 3 ¼ almost
Burnout is defined as physical or mental exhaustion caused always). Scores for the seven questions specific to each of the three
by overwork or stress. The MBI-9, a validated 9-item questionnaire, scales were summed with a possible score ranging from zero to 21.
is considered a criterion tool to measure manifestations of burnout Higher scores indicate greater levels of the emotional state.

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 JOEM  Volume 62, Number 8, August 2020 Mindfulness-based Yoga Intervention

TABLE 2. Outcome Scores at Baseline and Postintervention

Time Pointa
Subscale (Possible Range) Baseline (N ¼ 43) Post Yoga Sessions (N ¼ 42) P-Valueb Mean Difference (95% CI)

MBI-9 Emotional Exhaustion (0–18) 8.5 (6.7–10.3) 6.6 (5.4–7.8) 0.084 –1.89 (–4.05–0.26)
MBI-9 Depersonalization (0–18) 3.9 (2.7–5.1) 3.6 (2.4–4.8) 0.704 –0.31 (–1.94–1.32)
MBI-9 Personal Accomplishment (0–18) 12.3 (11.0–13.6) 15.3 (14.6–16.0) 0.001 3.00 (1.49–4.42)
DASS-21 Depression (0–21) 4.7 (2.9–6.6) 1.4 (0.8–1.9) 0.001 –3.36 (–5.28 to –1.44)
DASS-21 Anxiety (0–21) 6.6 (4.7–8.5) 1.8 (1.1–2.5) 0.001 –4.87 (–6.88 to –2.86)
DASS-21 Stress (0–21) 9.7 (7.9–11.6) 4.1 (2.9–5.3) 0.001 –5.63 (–7.78 to –3.48
RS-14 (14–98) 75.3 (69.4–81.1) 85.3 (81.0–89.6) 0.007 10.05 (2.88–17.22)
SCBC (5–35) 27.3 (25.4–29.2) 30.3 (29.2–31.4) 0.007 3.01 (0.84–5.18)

DASS-21, Depression Anxiety Stress Scales-21; MBI-9, Maslach Burnout Inventory; RS-14, 14-item Resilience Scale; SCBC, Santa Clara Brief Compassion Scale.
On MBI-9, higher scores on the Emotional Exhaustion and Depersonalization subscales, and lower scores on the Personal Accomplishment subscale indicate greater burnout. On
the DASS-21 subscales, higher scores indicate greater levels of that emotional state. On the RS-14, higher scores indicating greater resilience. On the SCBC, higher scores indicate
greater compassion.
a
Values shown are mean score (95% CI).
b
P-values were calculated with the linear mixed effects models and denote the significance of b coefficients.

The resilience scale (RS-14) measures the ability to recover were 2-sided with alpha of 0.05. The IBM SPSS (Statistical Package
from adversity.39 The scale has shown high internal and external for the Social Sciences), version 23 was used for these analyses. The
validity when used in a variety of populations.40 We used the study team used content analysis to analyze the open-ended
validated 14-term version in which participants recorded their responses. Two of the authors (SO-D and KN) coded the responses
degree of agreement to statements using a 7-point Likert scale independently with 0.90 interrater reliability.
(1 ¼ strongly disagree, 7 ¼ strongly agree). Scores were summed
with a possible score ranging from 14 to 98. Higher scores indicate RESULTS
higher resilience.
Participant Characteristics
Compassion All 43 participants completed the baseline survey and 42
Compassion is defined as ‘‘a deep awareness of the suffering (97.7%) provided data in the postintervention survey. The average
of another coupled with the wish to relieve it.’’41 We assessed age of participants was 36.8 (SD ¼ 11.2); 86% were female; and
compassion using the SCBC, which is a brief, validated index 42% were staff members (Table 1).
developed from the Sprecher and Fehr Compassionate Love Scale.42
The SCBC’s five questions measure compassion linked to prosocial Burnout
behaviors, for example, ‘‘When I hear about someone (a stranger) As shown in Table 2, participants’ baseline scores on MBI-9
going through a difficult time, I feel a great deal of compassion for was low. Respondents had significant increase from baseline to
him or her.’’ Participants recorded the extent to which each state- postintervention in MBI-9 personal accomplishment scores
ment was true for them using a 7-point scale (1 ¼ not at all true for (P < 0.01). Emotional exhaustion and depersonalization scores
me, 7 ¼ very true for me). Scores were summed with a possible showed no significant change.
score ranging from five to 35. Higher scores indicate
greater compassion. Depression, Anxiety, Stress, Resilience, and
Compassion
General Feedback Table 2 also shows the participants reported significant
The postintervention survey included an open-ended ques- improvement in depression (P < 0.01), anxiety (P < 0.01), and
tion: ‘‘Please provide any feedback on the mindfulness-based yoga stress (P < 0.01) DASS-21 scores after the intervention. Participants
sessions’’ to elicit participant feedback on the group mindfulness- also had a significant improvement in perceived resilience scores on
based yoga sessions. Participants also recorded the number of yoga RS-14 and in compassion scores (SCBC) post-intervention
activities (organized and/or personal) they completed during the 8- (P ¼ 0.007).
week period.
Outcome Measures and Number of Yoga Activities
Statistical Analysis To determine if a benefit threshold exists between the number of
We used standard descriptive statistics to create a demo- yoga activities and the outcomes measured, comparisons among the
graphic profile of the participants and screened for outliers. three yoga activity groups were conducted using one-way ANOVAs
Assumptions for normality and homogeneity of variance were with follow-up post hoc analyses. The results revealed significant
evaluated. Linear mixed models were used to estimate the effect differences among groups on all measures except MBI-9 depersonali-
of the mindfulness-based yoga on the outcome variables while zation, DASS-21 depression, and DASS-21 anxiety (Fig. 1).
adjusting for correlation due to repeated observations on each With respect to the MBI-9 measures, MBI-9 emotional
participant over the 8-week period. The number of completed yoga exhaustion (F[2,37] ¼ 3.98, P ¼ 0.027, h2 ¼ 0.18) and MBI-9 per-
activities was clustered into three groups (less than or equal to 5, 6 to sonal accomplishment (F[2,37] ¼ 9.1, P < 0.001, h2 ¼ 0.33) were
10, and more than or equal to 11), and compared on the scores of the significant. The follow-up post-hoc analyses revealed a significant
outcome measures (MBI-9, DASS-21, RS-14, and SCBC) using difference between groups less than or equal to five and more than or
one-way analysis of variance (ANOVA) with follow-up post-hoc equal to 11 (P ¼ 0.020) on MBI-9 emotional exhaustion. For MBI-9
analyses. This approach allowed us to estimate changes in the personal accomplishment, less than or equal to five group was
outcome measures during the postintervention period. All analyses significantly different from all the groups (P < 0.001).

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 Ofei-Dodoo et al JOEM  Volume 62, Number 8, August 2020

Abbreviated Maslach Burnout Inventory (MBI-9)

MBI-9 Emotional Exhaustion MBI-9 Depersonalization
MBI-9 Personal Accomplishment
20

15
Score, Mean

10

0
<6 sessions 6-10 sessions >10 sessions
Number of Yoga Activities

Depression Anxiety Stress Scales-21 (DASS-21)

DASS-21 Depression DASS-21 Anxiety DASS-21 Stress

7
6
5
Score, Mean

4
3
2
1
0
<6 sessions 6-10 sessions >10 sessions
Number of Yoga Activities

14-item Resilience Scale (RS-14) and Santa Clara

Brief Compassion Scale (SCBC)
RS-14 SCBC

120
100
Score, Mean

80
60
40
20
0
<6 sessions 6-10 sessions >10 sessions FIGURE 1. Means for the outcome
measures assessed by the number of
Number of Yoga Activities yoga activities participants engaged in
over the 8-week period.

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 JOEM  Volume 62, Number 8, August 2020 Mindfulness-based Yoga Intervention

TABLE 3. Participants’ Open-Ended Comments

Themes Sub-Themes Quotes From Participants

Psychological and Time to decompress ‘‘I used those times to decompress from all the craziness in the clinic.’’
Emotional Health [The sessions] ‘‘provided me with relaxation techniques that helped keep stress in
balance.’’
Selfcare ‘‘I don’t always make time for self-care. Scheduling these sessions allowed me to fit self-
care into my daily routine.’’
‘‘If we could have yoga taught even a few times a week at the school, we would be able
to better manage so many of the stressors we experience.’’
Refocus [The sessions] ‘‘helped [me] refocus.’’
‘‘I find it difficult to take breaks during my work day, so this is exactly what I needed to
help me to refocus.’’
Purpose in life ‘‘The sessions provided sense of purpose.’’
‘‘The yoga activities have given me a better perception about life.’’
Social Health Social interaction ‘‘The sessions provided a sense of connection to me. The social interaction, the discussion
sections, and the yoga activities have all given me a better perceptive about life.’’
‘‘Great time with work colleagues.’’
Sense of connection ‘‘I felt engaged and part of the group.’’
‘‘The sessions provided a sense of belongings and purpose in life.’’
Physical Health Improved physical health ‘‘I felt better, stronger, choose healthier habits because of this one hour a week.’’
‘‘The yoga sessions were of great value to me! I appreciated the ability to have a break in
the day to focus on body improvement.’’
Technical and Feedback on yoga sessions ‘‘This was absolutely the best thing the school has done for employees. I don’t care about
Other Feedback any of the events or activities, or even meals served.’’
‘‘I thoroughly enjoyed the yoga sessions.’’
Feedback on yoga instructor ‘‘The instructor was the best I have ever had. He is careful in his descriptions for people
who are new, and his prompts help people who have been doing this for years.’’
‘‘The instructor was knowledgeable and provided multiple alternatives for each pose.’’
Other ‘‘We should continue to do them [yoga] regularly.’’
‘‘It has been a true gift to have been able to do this for the past 2 months.’’

Regarding the DASS-21 measures, one-way ANOVA for and stress as well as improvement in resilience and compassion.
DASS-21 stress (F[2,37] ¼ 4.6, P ¼ 0.016, h2 ¼ 0.20) was signifi- These findings correlate with previous research findings of profes-
cant with post-hoc analysis revealing that the less than or equal to sionals in diverse work environments and are the first reported in a
five group was significantly different from group more than or equal medical school environment.26,27,29,31 The beneficial findings are
to 11 (P ¼ 0.017). particularly noteworthy given the relative short exposure to the
One-way ANOVA for RS-14 measure (F[2,37] ¼ 11.12, mindfulness-based yoga activities. While we believe that the effects
P < 0.001, h2 ¼ 0.38) was significant with follow-up post-hoc anal- would have been greater if the intervention had been longer and/or
ysis revealing that the less than or equal to five group was signifi- more intense the limited intervention may be sufficient to equip
cantly different from all the groups (P ¼ 0.02). Regarding the SCBC participants to continue mindfulness practices long term. A random-
measure, one-way ANOVA was significant (F[2,37] ¼ 9.10, ized controlled trial is warranted to confirm these promising findings.
P < 0.001, h2 ¼ 0.34) with follow-up post hoc analysis showing We were surprised by the low baseline scores for emotional
that less than or equal to five group was significantly different from exhaustion and depersonalization and the high personal accomplish-
all the other groups (P ¼ 0.02). ment scores. Even so, scores for emotional exhaustion and depersonal-
ization improved after the intervention. The observed lack of change in
Narrative Feedback the depersonalization scores may reflect a ceiling effect as the partic-
Analysis of the open-ended responses showed that the par- ipants already had low depersonalization score at baseline. Although
ticipants had a positive perception about the intervention. Three the scores on DASS-21 measures were within normal ranges at
major themes emerged: perceived improvements in psychological baseline, the measures improved significantly after the intervention.
and emotional health, social health, and physical health, plus The normal ranges on the measures might suggest that there is no need
general feedback on the activities, including the yoga instructor for clinical intervention, but the absence of disease and/or compromised
(Table 3). As shown in Fig. 2, the top three health benefits that emotional state, in this case depression, anxiety, and stress, does not
emerged from the responses were: an opportunity for decompres- suggest the presence of health and wellbeing.43 Preliminary findings
sion and for self-care, and enhanced purpose in life. All of these are have been encouraging, but the full importance and impact of happy,
within the psychological and emotional health category of the engaged, and healthy health care professionals, especially clinicians on
major themes. patient care outcomes is not fully understood.1,4–6,18,44
The significant positive improvement on resilience in these
DISCUSSION diverse members of health care professionals is important in
Our findings suggest that a relatively short workplace, group developing a workforce of professionals who can maintain
mindfulness-based yoga intervention may help reduce professional equilibrium in the face of stress and perceived risks.45,46 Expo-
burnout, support wellbeing, and improve compassion among health sure to stress while working in health care settings is inevitable,
care professionals. After 8 weeks of a program comprised of group but the intervention results suggest enhanced ability to thrive
discussions, mindfulness activities, and yoga practices, we found even in stressful and challenging situations, as well as enhancing
significant reductions in measures of burnout, depression, anxiety, physical and emotional wellbeing. Also, after the 8-week

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 Ofei-Dodoo et al JOEM  Volume 62, Number 8, August 2020

Physical health 6%

Social interaction 7%

Sense of connection 12%

Benefits

Refocus 12%

Purpose in life 14%

Self-care 16%

Decompression 33%
FIGURE 2. Participants’ comments
0% 5% 10% 15% 20% 25% 30% 35% regarding benefits of the mindfulness-
Responses based yoga intervention (Responses
¼ 72).

mindfulness intervention, we found a significant improvement in lack of control group makes it difficult to infer causation and
compassion scores among the participants. Compassionate love is reduces generalizability as there is no way to know if the improve-
defined as one’s attitude towards others that is ‘‘focused on caring, ments were direct effects of the mindfulness-based yoga interven-
concern, tenderness; an orientation towards supporting, helping, and tion. Additional research is warranted. The statistical findings
understanding other’’47 reflecting our need for social interactions and should be viewed cautiously because of the exploratory nature of
relationships.48 The workplace, group mindfulness-based yoga activ- the study. Given the size of our program, we could not report
ities provided such platform in the form of group discussion where findings based on career status (faculty, staff, and medical trainees)
participants shared experiences, supported and connected with one without compromising anonymity.
another, and encouraged collegiality.24,25 The improvement in the
compassion score is particularly important as compassion is nega- CONCLUSION
tively associated with emotional exhaustion (burnout) among health Burnout and other types of emotional distress are prevalent
care professionals.49–51 among physicians, medical trainees, and other health care profes-
These findings showed that the intervention helped even in sionals and associated decreased quality of patient care, suicidal
people who are doing well (not burned out). Rather than focusing on ideation, and reduced job satisfaction. Our findings suggest that a
evaluation and treatment of burnout, wellness studies should focus convenient short workplace mindfulness-based yoga intervention of
on prevention, anticipation, and positive approaches such as resil- weekly 1-hour sessions over eight weeks provided a collegial, and
ience, vitality, and wellness. Policy makers and health care insti- time-efficient way to improve personal accomplishment, resilience,
tutions need to find practical, affordable ways to promote wellness and compassion as well as reduction in depression, anxiety, and
among health care professionals. stress among health care professionals. Additional research is
Responses to the open-ended question revealed major benefits needed to confirm and expand on these findings. Future studies
of the yoga intervention to include decompression, self-care, refocus, should also investigate how many times per week participants
and sense of belonging among other benefits. These workplace, group engaged in mindfulness activities on their own, as opposed to group
mindfulness-based yoga activities provided participants the much- workplace activities in the 8-week period.
needed time and techniques to deal with work-related stress. As
evident in responses to the open-ended question, the mindfulness ACKNOWLEDGMENT
practices relaxed the body and calmed the mind through focusing on The authors thank Anne Walling, MB ChB of the University of
the present moment, the yoga activities improved physical wellbeing, Kansas School of Medicine for invaluable feedback on the manuscript.
and the group discussions provided shared experiences and collegi-
ality among the participants. Through this workplace supportive REFERENCES
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