ABOUT ESRT
Enhanced Stress Resilience Training (ESRT) is a custom-built program for surgeons and physicians that teaches vital cognitive habits to help them cope with stress, maintain emotional balance, and thrive in their professional lives. Since its inception in 2016, ESRT has been evaluated in two randomized clinical trials and multiple cohort studies, which have demonstrated a wide array of benefits including improved stress management, enhanced well-being, greater psychological resilience, and increased emotional regulation and self-awareness.
The ESRT program, based on Jon Kabat-Zinn Ph.D. 's Mindfulness Based Stress Reduction (MBSR) pioneered at the University of Massachusetts Medical School, has undergone nearly a decade of optimization and iterative adaptation for surgeons through human-centered design. Rigorous design, testing, and validation processes have also demonstrated the program's feasibility and acceptability within the realm of graduate surgical education.
ESRT focuses on teaching three main cognitive habits:
Meta-cognition
Perspective-taking
Developing a conscious awareness of one's own cognitive processes, allowing physicians to better understand their thoughts and emotions, and make more informed decisions.
Emotional regulation
Affective regulation
ESRT teaches non-reactivity to emotional stimuli, enabling physicians to maintain their composure and respond effectively even in emotionally charged situations.
Interoception
Situational awareness
This habit involves cultivating moment-to-moment awareness of one's thoughts, feelings, and sensations, improving overall self-awareness and situational awareness.
ESRT consists of five weekly 1-hour courses taught by instructors from the Center of Mindfulness in Surgery. The program follows the ESRT manual, which offers detailed information on the cognitive habits and techniques taught during the course. By incorporating meta-cognition, emotional regulation, and interoception, ESRT equips healthcare professionals to navigate their high-pressure work environment effectively.
Participant Feedback
Dr. Schwab on Respond vs React
Dr. Schwab is a general surgery resident at UCSF interested in an academic career in pediatric and fetal surgery.Dr. Ascher on Transforming Stress
A pioneer in the field of organ transplantation, Dr. Ascher holds the distinction of being the first woman to ever perform a liver transplant. She also spent two decades as Chair of the Department of Surgery at UCSF.“It’s allowed me to parse out my stress: lack of control makes me STRESSED. I’m learning to accept what I can’t change and let it go.
Breathing, letting it pass. I take mini-breaks inside my mind, then I focus better the remainder of the day.”
Dr. Harris on Informal Practice
Dr. Harris is a hepatobiliary surgeon at UCSF where he served as the Chief of the Division of Surgery from 2002 - 2020.Dr. Eyler on Everyday Use
Dr. Eyler is a general surgery resident at UCSF and co-creator of the EconomicClusters App, an algorithm that facilitates health disparities research in the context of low- and middle-income countries.Dr. Hansen on Why Participate
Dr. Hansen is a general surgery resident at UCSF and the founder of DIATIRŌ - a medical device company.“I thought I’d be learning a relaxation technique, but this is work. I didn’t believe in it at first, I thought it was sort of ridiculous, but it has changed me.
Practicing is work, but it feels like a gift…it’s changed how I think, how I see things, how things affect me.
Before I go in the OR to update the chief - especially if I have something that will upset him - I do the breathing, I focus, and I am clearer, explain better, am not nervous.”