The intervention was associated with significantly increased depression scores among patients of postintervention trainees ( mean score , 10.0 [ 95 % CI , 9.1 to 10.8 ] , compared with 8.8 [ 95 % CI , 8.4 to 9.2 ] ) for control conditions ; adjusted model showed an intervention effect of 2.2 ( 95 % CI , 0.6 to 3.8 ; P = .006 ) .