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Decreasing Stress and Burnout in Nurses: Efficacy of Blended Learning With Stress Management and Resilience Training Program

Magtibay, Donna L. MSN, RN; Chesak, Sherry S. PhD, RN; Coughlin, Kevin FNT; Sood, Amit MD

JONA: The Journal of Nursing Administration: July/August 2017 - Volume 47 - Issue 7/8 - p 391–395
doi: 10.1097/NNA.0000000000000501

OBJECTIVE The study’s purpose was to assess efficacy of blended learning to decrease stress and burnout among nurses through use of the Stress Management and Resiliency Training (SMART) program.

BACKGROUND Job-related stress in nurses leads to high rates of burnout, compromises patient care, and costs US healthcare organizations billions of dollars annually. Many mindfulness and resiliency programs are taught in a format that limits nurses’ attendance.

METHODS Consistent with blended learning, participants chose the format that met their learning styles and goals; Web-based, independent reading, facilitated discussions. The end points of mindfulness, resilience, anxiety, stress, happiness, and burnout were measured at baseline, postintervention, and 3-month follow-up to examine within-group differences.

RESULTS Findings showed statistically significant, clinically meaningful decreases in anxiety, stress, and burnout and increases in resilience, happiness, and mindfulness.

CONCLUSIONS Results support blended learning using SMART as a strategy to increase access to resiliency training for nursing staff.

Author Affiliations: Assistant Professor (Ms Magtibay) and Assistant Professor (Dr Chesak), Department of Nursing, and Consultant in General Internal Medicine and Professor of Medicine General Internal Medicine Division (Dr Sood), Mayo Clinic, Rochester; and Independent Consultant, Excelsior (Mr Coughlin), Minnesota.

Dr Sood developed the SMART program and has proprietary interest in it. Dr Sood was the lead interventionist but did not have any role in the data collection, analysis, or interpretation and did not have access to the original data at any time.

The authors declare no conflict of interest.

Correspondence: Ms Magtibay, Department of Nursing, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (

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