Authors: Elaibaid M et al.
Anesthesia & Analgesia, February 9, 2026, 10.1213/ANE.0000000000007983
This mixed-methods study evaluated Vital Anaesthesia Simulation Training (VAST) Wellbeing—a one-day course designed to address burnout and promote resilience—among healthcare providers working in an active conflict zone at the EMERGENCY-NGO Salam Centre for Cardiac Surgery in Sudan.
While VAST Wellbeing has previously been studied in low-resource environments, this is the first evaluation conducted in an active conflict setting.
Study Design
• 60 healthcare providers attended the course
• 35 completed quantitative measures
• 12 participated in in-depth qualitative interviews
Validated tools were used to measure:
• Perceived stigma associated with seeking psychological help (Stigma Scale for Receiving Psychological Help)
• Willingness to seek mental health support (General Help-Seeking Questionnaire)
Quantitative Findings
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Reduced stigma
Median stigma scores decreased significantly from precourse to postcourse (8.0 [IQR 6–9] vs 6.0 [3–8], P = .005). -
Increased willingness to seek help
Willingness to seek help significantly increased (3.4 [2.6–3.9] vs 4.6 [3.9–5.0], P > .001).
Qualitative Themes
Theme 1: Impact of conflict
Participants reported chronic fear, stress, and strain within both personal and workplace environments. Conflict-related uncertainty permeated daily work.
Theme 2: Social and workplace context
The program appeared to reduce stigma around discussing mental health and strengthened a sense of community among colleagues. Participants described subtle positive cultural shifts in the workplace.
Theme 3: Personal growth and behavioral change
Participants reported increased recognition of burnout symptoms and adoption of well-being practices. Mindfulness acceptance was mixed but generally acknowledged as beneficial.
Interpretation
The findings suggest that structured, even brief, well-being interventions can have measurable attitudinal impact—even in highly strained environments.
The reductions in stigma and increased help-seeking intent are particularly meaningful in settings where mental health support may carry social or cultural barriers.
Of note:
• This was not a burnout scale outcome study.
• Outcomes measured perceptions and attitudes rather than direct performance or long-term mental health endpoints.
• Sample size was modest.
• Follow-up duration was not long-term.
However, in a conflict context—where chronic stress exposure is extreme—the ability to measurably shift stigma and help-seeking attitudes through a single-day course is notable.
Key Points
• VAST Wellbeing decreased perceived stigma around mental health.
• Willingness to seek help increased significantly after the course.
• Conflict environment amplified baseline stress and psychological strain.
• Training fostered community cohesion and normalization of burnout discussions.
• Mindfulness practices were variably embraced but generally appreciated.
What You Should Know
Burnout interventions often show modest effects in conventional settings. Demonstrating impact in a conflict zone underscores the importance of structured psychological safety programming.
For large anesthesia teams—even outside conflict zones—the principles translate:
• Normalize mental health discussion
• Reduce stigma
• Build peer community support
• Provide practical coping skills
Short, structured interventions may have disproportionate cultural influence when delivered in environments under chronic stress.
Thank you to Anesthesia & Analgesia for allowing us to summarize and share this article.