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Both interventions were fully remote, self-paced, and designed to take 10\u201315\u00a0min per day, 5\u00a0days per week for 4\u00a0weeks. Primary outcomes were feasibility and acceptability; measures of impact included flourishing (Flourish Index) and burnout (Professional Fulfillment Index) at 8\u00a0weeks. Qualitative analysis of open-ended feedback and exit interviews was performed to understand participants\u2019 experience with the intervention, as well as barriers and facilitators of implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty-five medical students were enrolled and randomized. The OptimalWork group showed improvements in work engagement, burnout, anxiety, and stress, and an increase in overall flourishing. Dropout rates were high in both arms (46% by 4\u00a0weeks, 56% by 16\u00a0weeks), with lower baseline work engagement and higher stress predicting attrition. Qualitative analysis revealed that students who completed OptimalWork found it feasible, relevant, and helpful, while participants who dropped out cited time constraints and difficulty with daily habit formation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This pilot study demonstrates the feasibility of delivering a CBT-based digital intervention designed to improve well-being at work for medical students and offers insights into barriers and facilitators that can guide implementation efforts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov identifier: NCT06914843 (July 24, 2024, retrospectively registered).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s40596-026-02308-w","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T23:29:47Z","timestamp":1770420587000},"page":"559-570","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimizing the Work of Learning for Flourishing: A Randomized Pilot Study of a Digital CBT-Based Intervention in Medical Students"],"prefix":"10.1007","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4421-3078","authenticated-orcid":false,"given":"Justin S.","family":"Sanchez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Demetrius","family":"Perry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Kinghorn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Vermette","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teddi","family":"Gray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer G.","family":"Duncan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brad","family":"Evanoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ginger E.","family":"Nicol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,7]]},"reference":[{"issue":"1","key":"2308_CR1","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1186\/s12909-023-04460-5","volume":"23","author":"H Kaiser","year":"2023","unstructured":"Kaiser H, Grice T, Walker B, Kaiser J. 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OptimalWork was not involved in any aspect of the study, its analyses, or the drafting of this manuscript. DV is the recipient of a grant from the Kern National Network for Flourishing in Medicine. GN receives funding from NIH, Usona Institute, COMPASS Pathways, consults for Carelon, and participates on an Advisory Board for Alkermes. All other co-authors declare no conflicts of interest relevant to the content of this manuscript.","order":1,"name":"Ethics","label":"Disclosures","group":{"name":"EthicsHeading","label":"Declarations"}}]}}