Better Together Physician Coaching: An Innovative Solution to Medical Trainee Burnout
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 1,017
- 试验地点
- 2
- 主要终点
- Burnout as defined by the Maslach Burnout Inventory (MBI)
研究概览
简要总结
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. Women and those underrepresented in medicine (URM) experience a disproportionate amount of burnout likely due to the cognitive load required to manage microaggressions, stereotypes, and harmful socially adopted narratives around efficacy. 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 6-month coaching program for women residents 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). A pilot randomized controlled trial (RCT) of 101 BT participants demonstrated a statistically significant improvement in burnout, self-compassion, and imposter syndrome in the intervention group. BT will be scaled up to a national level and evaluated with an RCT mirroring our pilot in 10+ graduate medical education (GME) programs for 1000+ participants coordinated and evaluated by our CU team.
To accomplish this goal, the investigators set the following major objectives for this project:
- Prepare to expand the BT program by teaming with a cohort of diverse physician coaches.
- Implement BT in 10+ GME programs to serve 1000+ trainee participants with deliberate inclusion of institutions with diverse GME trainee populations serving geographically rural and/or medically underserved areas.
- Assess our outcomes: primary: reduce burnout as measured by the Maslach Burnout Index (goal: 10% relative improvement), and secondary: self-compassion, imposter syndrome and moral injury. Outcome generalizability and program feasibility at a national level will also be analyzed, as will participant experience to gain a richer understanding of how BT may help trainees, in particular those URM.
- Advance the field of coaching in GME through innovation and dissemination of evidence-based approaches to GME trainee wellbeing.
详细描述
Background and Significance:
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. Women and those underrepresented in medicine (URM) experience a disproportionate amount of burnout likely due to the cognitive load required to manage microaggressions, stereotypes, and harmful socially adopted narratives around efficacy. 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 6-month coaching program for women residents 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). A pilot randomized controlled trial (RCT) of 101 BT participants demonstrated a statistically significant improvement in burnout, self-compassion, and imposter syndrome in the intervention group. This project will scale Better Together up to a national level and evaluated with an RCT mirroring our pilot in 10+ graduate medical education (GME) programs for 1000+ participants coordinated and evaluated by our CU team.
III. Preliminary Studies/Progress Report:
Within the past year, Co-PIs Drs. Adrienne Mann and Tyra Fainstad (AM, TF) created and implemented Better Together Physician Coaching (Better Together, or BT) at the University of Colorado School of Medicine. BT is a coaching program for female identifying GME trainees at CU and its affiliate hospitals (Denver Health, Rocky Mountain Regional VA Medical Center, and The Children's Hospital). Using coaching techniques, BT challenges long-held paradigms fostered by medical training. BT aims primarily to reduce burnout as measured by the MBI with secondary aims to increase self-compassion, reduce imposter syndrome and decrease moral injury among residents who identify as women.
The Co-PIs (AM, TF) are both certified coaches through The Life Coach School™, a training institution for thought-based coaching. This type of coaching focuses on thoughts and beliefs. It combines a cognitive behavioral therapy (CBT) model with mindfulness-based awareness and integrates theories of acceptance and commitment therapy (ACT), nonattachment, and radical questioning from Socratic and Greek philosophies. BT delivers a robust coaching experience via a 6-month web-based, group-coaching model. This novel program allows residents to participate as actively as they are inclined and able, offering flexibility via multiple modalities of coaching: twice weekly group coaching calls, unlimited anonymous written coaching, and weekly self-study modules that are housed on a secure members-only website.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Sequential
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- Female
- 接受健康志愿者
- 是
入选标准
- •Medical trainees (residents or fellows)
- •Identify as female (including trans women, as well as those who identify as gender non-conforming, non-binary, and gender-queer).
排除标准
- •Non medical trainees
- •Those who do not identify as female (including trans women, as well as those who identify as gender non-conforming, non-binary, and gender-queer).
结局指标
主要结局
Burnout as defined by the Maslach Burnout Inventory (MBI)
时间窗: pretest will occur prior to the intervention and post test will occur after the 6 month intervention. A post-post test will occur 6 and 12 months after the intervention is done.
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.
次要结局
- Self-Compassion as defined by Neff's Self Compassion Score Short Form (SCS-SF)(pretest will occur prior to the intervention and post test will occur after the 6 month intervention. A post-post test will occur 6 and 12 months after the intervention is done.)