Better Together Physician Coaching to Mitigate Burnout in Male-Identifying Trainees

Not Applicable

Completed

• Conditions: Self Compassion; Flourishing; Burnout, Professional; Imposter Syndrome; Moral Injury
• Interventions: Behavioral: Better Together Physician Coaching Program; Behavioral: No intervention - placebo control

• Registration Number: NCT05550753
• Lead Sponsor: University of Colorado, Denver

Brief Summary

Better Together Physician Coaching ("Better Together", or "BT"), a 4-month, web-based positive psychology multimodal coaching program was built to decrease burnout in medical trainees. Here, the investigators seek to understand it's efficacy in male-identifying trainees at the University of Colorado

* Aim 1: Implement Better Together in for male-identifying trainees in Graduate Medical Education at the University of Colorado.

* Aim 2: Assess outcomes: primary: reduce burnout as measured by the Maslach Burnout Index (goal: 10% relative improvement), and secondary: self-compassion, imposter syndrome, flourishing and moral injury.

* Aim 3: Advance the field of coaching in GME through innovation and dissemination of evidence-based approaches to GME trainee wellbeing.

Detailed Description

Burnout refers to feelings of exhaustion, negativism, and reduced personal efficacy resulting from chronic workplace stress. In healthcare, burnout leads to increased medical errors, poorer patient care and negatively affects professional development and retention. Burnout is a growing problem that begins early in medical training. Professional coaching is a metacognition tool with a sustainable positive effect on physician well-being but typically relies on expensive consultants or time-consuming faculty development, often making it infeasible for medical training programs to offer. To overcome this barrier, the investigators created Better Together Physician Coaching (BT) a 4-month coaching program for at the University of Colorado (CU). BT includes regular online group-coaching, written coaching, and weekly self-study modules delivered by physician life coaches (Co-PIs). In 2021, the investigators studied BT in a group of female-identifying resident trainees at CU and found that the program significantly improved burnout, imposter syndrome, and self-compassion.6 This finding supports previous data that life coaching is effective for physicians and physicians in training. The investigators initially focused on women since burnout affects women to a greater degree than their male counterparts, and may have long-lasting consequences on their careers, contributing to a "leaky pipeline" effect. The pilot randomized controlled trial (RCT) of 101 BT women participants demonstrated a statistically significant improvement in burnout, self-compassion, and imposter syndrome in the intervention group.

The investigators now seek to understand if the coaching program is also effective in male-identifying medical trainees. There is some literature suggesting that women are more likely to engage in wellness interventions, and may be more likely to report symptoms of burnout on surveys than men despite actual experiences. There is data to suggest that men and women are affected to different degrees by wellness interventions and there is also data that shows different effects (both positive and negative) of mixing genders. The investigators eventually plan to offer coaching to a co-ed group however realize that if efficacy is different in this group, it will be unknown if the difference is due to men being affected to a different degree than women, or if the difference is due to mixing the genders. Before testing the program in a co-ed group, the investigators first need to see if the coaching is effective in men. This project will test Better Together amongst male-identifying participants, and the program will be evaluated by the CU research team to see if the program has the same impacts.

The hypothesis is that Better Together Physician Coaching ("Better Together", or "BT"), a 4-month, web-based positive psychology multimodal coaching program will result in decreased burnout in male-identifying residents in medical training at CU.

* Aim 1: Implement Better Together in for male-identifying trainees in Graduate Medical Education at the University of Colorado.

* Aim 2: Assess outcomes: primary: reduce burnout as measured by the Maslach Burnout Index (goal: 10% relative improvement), and secondary: self-compassion, imposter syndrome, flourishing and moral injury.

* Aim 3: Advance the field of coaching in GME through innovation and dissemination of evidence-based approaches to GME trainee wellbeing.

Study Timeline

• Study First Submitted: 2022-09-19
• Study First Submitted QC: 2022-09-19
• Study First Posted: 2022-09-22
• Study Start: 2023-01-02
• Status Verified: 2023-09
• Primary Completion: 2023-09-01
• Study Completion: 2023-09-01
• Last Update Submitted: 2023-09-26
• Last Update Posted: 2023-09-28

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Male
• Target Recruitment: 41

Inclusion Criteria

• trainee (resident or fellow) in graduate medical education at the University of Colorado, who identify as male (cis, transman, gender-queer, non-binary are welcome).

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Exclusion Criteria

• non-trainee, non male-identifying

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SEQUENTIAL

Arm && Interventions

Group	Intervention	Description
Intervention	Better Together Physician Coaching Program	Will be offered the BT coaching intervention during of 4-months (February 1st 2023- May 31st 2023).
Control	No intervention - placebo control	Will NOT be offered the BT coaching intervention during of 4-months (February 1st 2023- May 31st 2023). Will be offered the coaching intervention after the study completion (from September 1st 2023 - December 31st 2023).

Primary Outcome Measures

Name	Time	Method
Burnout as defined by the Maslach Burnout Inventory (MBI).	pretest will occur prior to the intervention and posttest will occur after the 4-month intervention.	The Maslach burnout inventory (MBI) is a 22-item measurement of worker burnout which assesses emotional exhaustion (EE), depersonalization (DP), and personal fulfillment (PF) domains. Possible scores range from 0-6 on a Likert scale for each item. Scores of EE ≥ 27 points, DP ≥ 10, and PF \<33 would indicate a high degree of burnout. Scores of EE≤18 points, DP≤5 points, and PF≥40 points would indicate a low degree of burnout.

Secondary Outcome Measures

Name	Time	Method
Moral Injury as defined by the Moral Injury Symptom Scale for Health Professions (MISS-HP)	pretest will occur prior to the intervention and posttest will occur after the 4-month intervention	Moral Injury Symptom Scale for Health Professions (MISS-HP) is a 10-item measurement of moral injury. Possible scores range from 0-5 on a Likert scale for each item, where the higher scale scores indicate greater moral injury. Scores \>35(on a possible score range of 10 to 100) are considered high for moral injury symptoms causing moderate to extreme problems with family, social, and occupational functioning.
Self-Compassion as defined by Neff's Self Compassion Score Short Form (SCS-SF)	pretest will occur prior to the intervention and posttest will occur after the 4-month intervention	Neff's Self Compassion Score Short Form (SCS-SF) is a 12-item measurement of self-compassion. Possible scores range from 0-6 on a Likert scale for each item, where the higher scale scores indicate greater self-compassion. Scores of 1.0- 2.49 are considered to be low, between 2.5-3.5 to be moderate, and 3.51-5.0 to be high.
Flourishing as defined by the Secure Flourish Index (SFI)	pretest will occur prior to the intervention and posttest will occur after the 4-month intervention	The Secure Flourish Index (SFI) is a 12 item measurement of flourishing at work and includes the domains of (D1) happiness and life satisfaction; (D2) physical and mental health; (D3) meaning and purpose; (D4) character and virtue; and (D5) close social relationships plus 2 questions on having adequate stability as well as material and financial resources so that flourishing is likely to continue. Scores range from a low of 0 to a high of 120, though the secure flourishing scores are often reported as averages of the questions (rather than sums) so that all scores are on a scale of 0-10.
Imposter Syndrome as defined by Young's Imposter Syndrome Symptoms Scale (YISS)	pretest will occur prior to the intervention and posttest will occur after the 4-month intervention	Young's Imposter Syndrome Symptoms Scale (YISS) is a 8-item measurement of imposter syndrome. Scoring is yes/no where a score of \>5/8 is felt to be positive for imposter syndrome.

Trial Locations

Locations (1)

University of Colorado School of Medicine; 🇺🇸 Aurora, Colorado, United States