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Houchens N, Kuhn L, Ratz D, Su GL, Saint S. Committed to Success: A Structured Mentoring Program for Clinically Oriented Physicians. Mayo Clin Proc Innov Qual Outcomes 2024; 8:356-363. [PMID: 38974530 PMCID: PMC11225678 DOI: 10.1016/j.mayocpiqo.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024] Open
Abstract
Objective To examine impacts of a structured mentorship committee program on academic promotion and participant perceptions because impacts of formal mentorship programs for clinical faculty are unknown. Participants and Methods This prospective cohort study at a Midwestern Veterans Affairs tertiary care system from December 17, 2019 to December 31, 2022 included clinical track faculty in the Medicine Service below the rank of Clinical Associate Professor. Mentoring meetings (mentee, committee chair, and mentors) were generally held twice annually. All participants were surveyed after each meeting (response rate: 100%). Results All 23 of 23 (100%) eligible faculty were enrolled as mentees, and 49 distinct meetings occurred. Three (13%) mentees were promoted, and the remaining 20 (87%) continued in the program. Mean scores (SD), scaled 1 (strongly disagree) to 5 (strongly agree), for mentors and mentees were 4.71 (0.51) and 4.80 (0.54) for "effective use of my time"; 4.58 (0.64) and 4.37 (0.49) for "appropriate progress since last meeting"; 4.52 (0.66) and 4.31 (0.64) for "program increased my work satisfaction"; and 4.07 (0.96) and 3.75 (0.92) for "program reduced my work burnout," respectively. Conclusion Clinically oriented physicians viewed the program positively. It appeared to help junior faculty get promoted and led to improved work satisfaction and reduced burnout.
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Affiliation(s)
- Nathan Houchens
- Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI
- Division of Hospital Medicine, Department of Medicine, University of Michigan, Ann Arbor
| | - Latoya Kuhn
- Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI
- Division of Hospital Medicine, Department of Medicine, University of Michigan, Ann Arbor
| | - David Ratz
- Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI
| | - Grace L. Su
- Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Michigan, Ann Arbor
| | - Sanjay Saint
- Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI
- Division of Hospital Medicine, Department of Medicine, University of Michigan, Ann Arbor
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Smith S, Goldhaber N, Maysent K, Lang U, Daniel M, Longhurst C. Impact of a virtual coaching program for women physicians on burnout, fulfillment, and self-valuation. BMC Psychol 2024; 12:331. [PMID: 38840137 PMCID: PMC11155151 DOI: 10.1186/s40359-024-01763-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 05/02/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Coaching has been demonstrated to be an effective physician wellness intervention. However, this evidence-based intervention has not yet been widely adopted in the physician community. Documentation and implementation research of interventions to address physician burnout in real world settings is much needed. OBJECTIVE Assess the impact of a virtual physician coaching program in women physicians. DESIGN Pre- and post-intervention surveys administered to participants enrolled in the program (N = 329). Effect size was calculated comparing pre- and post-intervention paired data (N = 201). PARTICIPANTS 201 women physicians from 40 states in the United States of America and 3 international participants. INTERVENTIONS Participants were given access to an 8 week virtual coaching program including eight individual, six small group, and 24 large group sessions. MAIN MEASURES Stanford Professional Fulfillment Inventory (PFI) containing categories for assessing professional fulfillment, burnout, and the Clinician Self-Valuation (SV) Scale (a measure of self-compassion). KEY RESULTS Burnout was found in 77.1% (N = 155) of participants at baseline, which reduced to 33.3% (N = 67) at completion with large effect size (Cohen's d 1.11). The percentage of participants who endorsed significant professional fulfillment started at 27.4% (N = 55) and improved to 68.2% (N = 137) with a large effect size (Cohen's d 0.95). Self-valuation improved from 17.9% (N = 36) of the participants endorsing a compassionate self-improvement perspective to 64% of the same participants eight weeks later. The self-valuation metric showed a very large effect size (Cohen's d 1.28). CONCLUSIONS Virtual physician coaching programs led by physician coaches can decrease burnout, improve professional fulfillment, and increase self-compassion. Non-institution-based opportunities for coaching available to any physician across the United States and internationally can facilitate access to effective physician well-being interventions.
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Affiliation(s)
- Sunny Smith
- Empowering Women Physicians, 4653 Carmel Mountain Rd. #308-201, San Diego, CA, 92130, USA.
| | | | - Kathryn Maysent
- Office of the Chief Medical Officer, University of California, San Diego, USA
| | - Ursula Lang
- Department of Pathology, University of California, San Francisco, USA
| | - Michelle Daniel
- Department of Emergency Medicine, University of California, San Diego, USA
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Gold CA, Jensen R, Sasnal M, Day HS, Miller-Kuhlmann RK, Blankenburg RL, Rassbach CE, Morris AM, Korndorffer JR, Nassar AK. Impact of a coaching program on resident perceptions of communication confidence and feedback quality. BMC MEDICAL EDUCATION 2024; 24:435. [PMID: 38649901 PMCID: PMC11036561 DOI: 10.1186/s12909-024-05383-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 04/02/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND While communication is an essential skill for providing effective medical care, it is infrequently taught or directly assessed, limiting targeted feedback and behavior change. We sought to evaluate the impact of a multi-departmental longitudinal residency communication coaching program. We hypothesized that program implementation would result in improved confidence in residents' communication skills and higher-quality faculty feedback. METHODS The program was implemented over a 3-year period (2019-2022) for surgery and neurology residents at a single institution. Trained faculty coaches met with assigned residents for coaching sessions. Each session included an observed clinical encounter, self-reflection, feedback, and goal setting. Eligible residents completed baseline and follow-up surveys regarding their perceptions of feedback and communication. Quantitative responses were analyzed using paired t-tests; qualitative responses were analyzed using content analysis. RESULTS The baseline and follow-up survey response rates were 90.0% (126/140) and 50.5% (46/91), respectively. In a paired analysis of 40 respondents, residents reported greater confidence in their ability to communicate with patients (inpatient: 3.7 vs. 4.3, p < 0.001; outpatient: 3.5 vs. 4.2, p < 0.001), self-reflect (3.3 vs. 4.3, p < 0.001), and set goals (3.6 vs. 4.3, p < 0.001), as measured on a 5-point scale. Residents also reported greater usefulness of faculty feedback (3.3 vs. 4.2, p = 0.001). The content analysis revealed helpful elements of the program, challenges, and opportunities for improvement. Receiving mentorship, among others, was indicated as a core program strength, whereas solving session coordination and scheduling issues, as well as lowering the coach-resident ratio, were suggested as some of the improvement areas. CONCLUSIONS These findings suggest that direct observation of communication in clinical encounters by trained faculty coaches can facilitate long-term trainee growth across multiple core competencies. Future studies should evaluate the impact on patient outcomes and workplace-based assessments.
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Affiliation(s)
- Carl A Gold
- Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Rachel Jensen
- Department of Surgery, Stanford University School of Medicine, 300 Pasteur Drive, H3639, Stanford, CA, 94305, USA
| | - Marzena Sasnal
- Department of Surgery, Stanford-Surgery Policy Improvement Research and Education Center (S-SPIRE), Stanford University School of Medicine, Stanford, CA, USA
| | - Heather S Day
- Department of Surgery, Stanford-Surgery Policy Improvement Research and Education Center (S-SPIRE), Stanford University School of Medicine, Stanford, CA, USA
| | - Rebecca K Miller-Kuhlmann
- Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Caroline E Rassbach
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Arden M Morris
- Department of Surgery, Stanford-Surgery Policy Improvement Research and Education Center (S-SPIRE), Stanford University School of Medicine, Stanford, CA, USA
| | - James R Korndorffer
- Department of Surgery, Stanford University School of Medicine, 300 Pasteur Drive, H3639, Stanford, CA, 94305, USA
| | - Aussama K Nassar
- Department of Surgery, Stanford University School of Medicine, 300 Pasteur Drive, H3639, Stanford, CA, 94305, USA.
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Becker A, Sullivan EE, Leykum LK, Brown R, Linzer M, Poplau S, Sinsky C. Burnout Among Hospitalists During the Early COVID-19 Pandemic: a National Mixed Methods Survey Study. J Gen Intern Med 2023; 38:3581-3588. [PMID: 37507550 PMCID: PMC10713906 DOI: 10.1007/s11606-023-08309-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/28/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND : Hospitalist physician stress was exacerbated by the pandemic, yet there have been no large scale studies of contributing factors. OBJECTIVE Assess remediable components of burnout in hospitalists. PARTICIPANTS, STUDY DESIGN AND MEASURES In this Coping with COVID study, we focused on assessment of stress factors among 1022 hospital-based clinicians surveyed between April to December 2020. We assessed variables previously associated with burnout (anxiety/depression due to COVID-19, work overload, fear of exposure or transmission, mission/purpose, childcare stress and feeling valued) on 4 point Likert scales, with results dichotomized with the top two categories meaning "present"; burnout was assessed with the Mini Z single item measure (top 3 choices = burnout). Quantitative analyses utilized multilevel logistic regression; qualitative analysis used inductive and deductive methods. These data informed a conceptual model. KEY RESULTS Of 58,408 HCWs (median response rate 32%), 1022 were hospital-based clinicians (906 (89%) physicians; 449 (44%) female; 469 (46%) White); 46% of these hospital-based clinicians reported burnout. Work overload was associated with almost 5 times the odds of burnout (OR 4.9, 95% CIs 3.67, 6.85, p < 0.001), and those with anxiety or depression had 4 times the odds of burnout (OR 4.2, CIs 3.21, 7.12, p < 0.001), while those feeling valued had half the burnout odds (OR 0.43, CIs 0.31, 0.61, p < 0.001). Regression models estimated 42% of burnout variance was explained by these variables. In open-ended comments, leadership support was helpful, with "great leadership" represented by transparency, regular updates, and opportunities to ask questions. CONCLUSIONS In this national study of hospital medicine, 2 variables were significantly related to burnout (workload and mental health) while two variables (feeling valued and leadership) were likely mitigators. These variables merit further investigation as means of reducing burnout in hospital medicine.
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Affiliation(s)
| | - Erin E Sullivan
- Sawyer Business School, Suffolk University, Boston, MA, USA
- Harvard Medical School Center for Primary Care, Boston, MA, USA
| | - Luci K Leykum
- The University of Texas at Austin, Dell Medical School, Austin, TX, USA
- South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Roger Brown
- University of Wisconsin School of Nursing, Madison, WI, USA
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Schulte EE. Enhancing Leadership and Faculty Development: The Benefits of Coaching for Physician Leaders. J Pediatr 2023:113827. [PMID: 37979934 DOI: 10.1016/j.jpeds.2023.113827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 11/13/2023] [Indexed: 11/20/2023]
Affiliation(s)
- Elaine E Schulte
- Department of Pediatrics, the Albert Einstein College of Medicine, Bronx, NY, and the Children's Hospital at Montefiore, Bronx, NY.
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Laverdure M, Gomez-Garibello C, Snell L. Residents as Medical Coaches. JOURNAL OF SURGICAL EDUCATION 2023; 80:1067-1074. [PMID: 37271599 DOI: 10.1016/j.jsurg.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/25/2023] [Accepted: 05/08/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVES With the recent implementation of Competency-based Medical Education (CBME) and emphasis on direct observation of learners, there is an increased interest in the concept of clinical coaching. While there is considerable literature on the role of attending physicians as coaches, little data is available on the role of residents as coaches, and residents' perceptions about effective coaching. We aimed to identify distinct characteristics of residents' coaching, to examine residents' perceptions on what they valued most in clinical coaches, and to explore trainees' ideas about how to optimize this role. DESIGN We performed an exploratory qualitative study, using 45 minutes semi-structured interviews. We did a thematic analysis of the interview transcripts using both inductive and deductive coding. PARTICIPANTS We invited and interviewed 5 surgical and 5 nonsurgical residents, and 3 surgical and 3 nonsurgical attending staff. Residents were recruited from all post graduate levels and from a variety of programs. SETTING Our study was done in a large tertiary teaching hospital. RESULTS Residents perceived that they have a significant role as coaches for junior learners, different from the attending's role. The proximity between the coach and the coaches leads to a different supervisor-learner rapport. This was of benefit as learners described feeling more comfortable making mistakes and seeking feedback, which potentiates effective coaching. Residents reported feeling that it was easier to coach their recently-acquired skills as the subtleties of the tasks and the troubleshooting were fresher in memory. Residents expressed appreciating a coach who values autonomy and does not intervene except when patient safety is at risk. Strategies identified to further optimize residents' role as coaches include placing coaching as a priority, ensuring dedicated time, and offering teaching sessions on coaching. CONCLUSIONS Residents have distinct roles as coaches, driven by their recent experience being coached and as near peers. More research is needed to evaluate concrete measures to optimize residents' role as coaches and to improve their coaching skills.
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Affiliation(s)
- Morgane Laverdure
- Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada.
| | | | - Linda Snell
- Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada; Institute of Health Sciences Education, McGill University, Montreal, Quebec, Canada
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Merrill AL, Stein SL, Chu JT, Sarode AL, McKinley SK, Parangi S, Donelan K, Palamara K. Do Resident Coaching Programs Benefit their Coaches? Impact of a Professional Development Coaching Program on The Coaches. World J Surg 2023; 47:1609-1616. [PMID: 36847851 PMCID: PMC9969939 DOI: 10.1007/s00268-023-06957-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Coaching has been shown to decrease physician burnout; however, coachee outcomes have been the focus. We report the impact of coaching on women-identifying surgeons who participated as coaches in a 9-month virtual program. METHODS A coaching program was implemented in the Association of Women Surgeons (AWS) to determine the effects of coaching on well-being and burnout from 2018 to 2020. AWS members volunteered and completed training in professional development coaching. Pre- and post-study measures were assessed, and bivariate analysis performed based on burnout and professional fulfillment score. RESULTS Seventy-five coaches participated; 57 completed both pre- and post-study surveys. There were no significant changes in burnout or professional fulfillment including the Positive Emotion, Engagement, Relationship, Meaning, and Accomplishment scale, hardiness, self-valuation, coping, gratitude, or intolerance of uncertainty scores from baseline to post-survey. On bivariate analysis, hardiness was associated with lower burnout throughout the duration of the program. Coaches with lower burnout at the end of the program met with their coachee more frequently than coaches with higher burnout [mean (SD) 3.95(2.16) versus 2.35(2.13) p = 0.0099]. DISCUSSION Burnout and professional fulfillment demonstrated no change in women surgeons who participated as professional development coaches. Those with lower burnout and higher professional fulfillment at the end of the program were found to have higher hardiness, which may be worth future investigation. CONCLUSIONS Acquisition of coaching skills did not directly improve well-being in faculty who participated in a resident coaching program. Future studies would benefit from control groups and exploration of qualitative benefits of coaching.
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Affiliation(s)
- Andrea L Merrill
- Department of Surgery, Boston Medical Center, 820 Harrison Avenue, FGH Building- Suite 5005, Boston, MA, 02118, US.
| | - Sharon L Stein
- Department of Surgery, University Hospitals Cleveland, Cleveland, OH, US
- Association of Women Surgeons, Chicago, IL, US
| | - Jacqueline T Chu
- Department of Medicine, Massachusetts General Hospital, Boston, MA, US
| | - Anuja L Sarode
- Department of Surgery, University Hospitals Cleveland, Cleveland, OH, US
| | - Sophia K McKinley
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, US
| | - Sareh Parangi
- Association of Women Surgeons, Chicago, IL, US
- Department of Surgery, Massachusetts General Hospital, Boston, MA, US
| | - Karen Donelan
- Institute On Healthcare Systems, Heller School of Social Policy and Management, Brandeis University, Boston, MA, US
| | - Kerri Palamara
- Department of Medicine, Massachusetts General Hospital, Boston, MA, US
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8
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Stewart MK, Kao LS. Coaching the Coach to Reduce Burnout: Commentary on Do Resident Coaching Programs Benefit Their Coaches? Impact of a Professional Development Coaching Program on the Coaches. World J Surg 2023; 47:1617-1618. [PMID: 37060365 DOI: 10.1007/s00268-023-07015-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2023] [Indexed: 04/16/2023]
Affiliation(s)
- Melissa K Stewart
- Department of Surgery, McGovern Medical School at UTHealth Houston, 6431 Fannin Street, MSB 4.264, Houston, TX, 77030, USA
| | - Lillian S Kao
- Department of Surgery, McGovern Medical School at UTHealth Houston, 6431 Fannin Street, MSB 4.264, Houston, TX, 77030, USA.
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James TT, Hudon R, Merrick T, Olson L, Hanes D, Scanlan JM. Creating a Comprehensive Pandemic Response to Decrease Hospitalist Burnout During COVID-19: Intervention vs Control Results in 2 Comparable Hospitals (HOSP-CPR). J Gen Intern Med 2023; 38:1256-1263. [PMID: 36764984 PMCID: PMC9918339 DOI: 10.1007/s11606-023-08041-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 01/13/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND Physician burnout increased during the COVID-19 pandemic. OBJECTIVE To evaluate the effectiveness of a multimodal workplace intervention designed to reduce hospitalist burnout. DESIGN Participants and setting: Our intervention group was composed of internal medicine hospitalists at Providence Portland Medical Center (64 providers including 58 physicians and 6 nurse practitioners). Our control was composed of internal medicine hospitalists at Providence St Vincent's Hospital (59 physicians and 6 nurse practitioners). MEASUREMENTS Two surveys were given during, before, and after a 12-month intervention period (October 2020 and again in October 2021). Surveys included demographics, job satisfaction, the Maslach Burnout Inventory, the Pandemic Experiences Survey, and 2 questions about leaving the job. INTERVENTIONS Three hospitalists designated as wellness warriors created weekly COVID group meetings, providing up-to-date information about COVID-19 infection rates, treatments, and work-flow changes. Discussions included coping and vaccine hesitancy, difficult case debriefs, and intensive care unit updates. Individual coaching was also offered. Meeting minutes were taken and sessions were recorded for asynchronous access. RESULTS No site differences in burnout or job satisfaction were evident pre-intervention. Post-intervention, the intervention group reported 32% burnout while controls reported 56% (p = .024). Forty-eight percent of the intervention group reported high wellness support vs. 0% of the controls (< .001). Intervention participants attributed 44% of wellness support to Providence alone, vs. controls at 12% (< .001). Regressions controlling sex, work hours, experience, race, and children in the home showed the intervention's positive effects on burnout and job satisfaction remained significant (all p < .02). LIMITATIONS For privacy reasons, all survey responses were anonymous, meaning that individual pre-post changes could not be tracked. CONCLUSION We believe the intervention resulted in substantial burnout prevention and is feasible for adoption in most hospitals and clinics.
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Affiliation(s)
- Tricia T James
- Department of Medical Education, Providence Portland Medical Center, 5050 NE Hoyt Suite 540, Portland, OR, 97213, USA.
| | - Robert Hudon
- Department of Hospital Medicine, Providence Portland Medical Center, Portland, OR, USA
| | - Todd Merrick
- Department of Hospital Medicine, Providence Portland Medical Center, Portland, OR, USA
| | - Lisa Olson
- Department of Hospital Medicine, Providence Portland Medical Center, Portland, OR, USA
| | - Douglas Hanes
- Center for Cardiovascular Analytics, Research + Data Science, Providence Research Network, Portland, OR, USA
| | - James M Scanlan
- Providence Health Research Accelerator (HRA), Seattle, WA, USA
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Boet S, Etherington C, Dion PM, Desjardins C, Kaur M, Ly V, Denis-LeBlanc M, Andreas C, Sriharan A. Impact of coaching on physician wellness: A systematic review. PLoS One 2023; 18:e0281406. [PMID: 36749760 PMCID: PMC9904500 DOI: 10.1371/journal.pone.0281406] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/20/2023] [Indexed: 02/08/2023] Open
Abstract
Physician wellness is critical for patient safety and quality of care. Coaching has been successfully and widely applied across many industries to enhance well-being but has only recently been considered for physicians. This review aimed to summarize the existing evidence on the effect of coaching by trained coaches on physician well-being, distress and burnout. MEDLINE, Embase, ERIC, PsycINFO and Web of Science were searched without language restrictions to December 21, 2022. Studies of any design were included if they involved physicians of any specialty undergoing coaching by trained coaches and assessed at least one measure along the wellness continuum. Pairs of independent reviewers determined reference eligibility. Risk of bias was assessed using the Cochrane Risk of Bias Tools for Randomized Controlled Trials (RCTs) and for Non-randomized Studies of Interventions (ROBINS-I). Meta-analysis was not possible due to heterogeneity in study design and outcome measures as well as inconsistent reporting. The search retrieved 2531 references, of which 14 were included (5 RCTs, 2 non-randomized controlled studies, 4 before-and-after studies, 2 mixed-methods studies, 1 qualitative study). There were 1099 participants across all included studies. Risk of bias was moderate or serious for non-RCTs, while the 5 RCTs were of lower risk. All quantitative studies reported effectiveness of coaching for at least one outcome assessed. The included qualitative study reported a perceived positive impact of coaching by participants. Evidence from available RCTs suggests coaching for physicians can improve well-being and reduce distress/burnout. Non-randomized interventional studies have similar findings but face many limitations. Consistent reporting and standardized outcome measures are needed.
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Affiliation(s)
- Sylvain Boet
- Department of Anesthesiology and Pain Medicine, Hyperbaric Medicine Unit, The Ottawa Hospital, Ottawa, Canada,Department of Innovation in Medical Education, The Ottawa Hospital, Ottawa, Canada,Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Canada,Institut du Savoir Montfort, Ottawa, Canada,Faculty of Education, University of Ottawa, Ottawa, Canada,* E-mail:
| | - Cole Etherington
- Department of Anesthesiology and Pain Medicine, Hyperbaric Medicine Unit, The Ottawa Hospital, Ottawa, Canada,Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Pierre-Marc Dion
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Canada,Francophone Affairs, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Chloé Desjardins
- Francophone Affairs, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Manvinder Kaur
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Valentina Ly
- Health Sciences Library, University of Ottawa, Ottawa, Canada
| | | | - Cecile Andreas
- Professional and Continuing Studies, Royal Roads University, Victoria, Canada
| | - Abi Sriharan
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
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Impact of a Virtual Professional Development Coaching Program on the Professional Fulfillment and Well-Being of Women Surgery Residents: A Randomized Controlled Trial. Ann Surg 2023; 277:188-195. [PMID: 35766397 DOI: 10.1097/sla.0000000000005562] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Evaluate the effect of a virtual coaching program offered to women surgery residents in a surgical society. BACKGROUND Randomized controlled experiments evaluating the effect of coaching on trainee well-being and burnout is lacking. METHODS Women surgery residents in the Association of Women Surgeons were recruited to participate in a randomized controlled trial of the effects of a virtual coaching program on trainee well-being. Attending surgeons served as coaches after completing in-person training. Residents (n=237) were randomized to intervention (three 1:1 coaching sessions over 9 mo) or control (e-mailed wellness resources). Participants were surveyed at baseline and postintervention using validated measures of well-being, burnout, and resilience. Changes in outcome measures between presurvey and postsurvey were compared between study arms. RESULTS Survey response rates were 56.9% (n=66) in the control group and 69.4% (n=84) in the intervention group ( P =0.05). The intervention group showed significant improvement in professional fulfillment ( P =0.021), burnout (0.026), work exhaustion (0.017), self-valuation (0.003), and well-being ( P =0.002); whereas the control group showed significant improvement in self-valuation ( P =0.015) and significant decline in resilience ( P =0.025). The intervention group had a significant improvement in well-being ( P =0.015) and intolerance of uncertainty ( P =0.015) compared to controls. CONCLUSIONS Women surgery residents who participated in a remote coaching program offered by a surgical society demonstrated improvement in aspects of well-being relative to peers who did not receive coaching. Therefore, remote coaching offered by a professional society may be a useful component of initiatives directed at trainee well-being.
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Mann A, Fainstad T, Shah P, Dieujuste N, Thurmon K, Dunbar K, Jones C. "We're all going through it": impact of an online group coaching program for medical trainees: a qualitative analysis. BMC MEDICAL EDUCATION 2022; 22:675. [PMID: 36100880 PMCID: PMC9468533 DOI: 10.1186/s12909-022-03729-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Trainees in graduate medical education are affected by burnout at disproportionate rates. Trainees experience tremendous growth in clinical skills and reasoning, however little time is dedicated to metacognition to process their experiences or deliberate identity formation to create individualized definitions of success and wellbeing. The purpose of this study was to understand the perspectives and experiences of trainees who participated in a 6-month, web-based, group coaching program for women residents in training. METHODS Better Together Physician Coaching is a six-month, self-paced, online, asynchronous, coaching program with multiple components including live coaching calls, unlimited written coaching, and self-study modules. Semi-structured interviews of seventeen participants of Better Together from twelve GME programs within a single institution in Colorado were conducted from May to June of 2021. All identified as women and had participated in a 6-month coaching program. Both inductive and deductive methods were used in collecting and analyzing the data with an aim to understand learners' perceptions of the coaching program, including "how and why" the coaching program affected training experiences and wellbeing. RESULTS Three main themes emerged as benefits to the coaching program from the data: 1) practicing metacognition as a tool for healthy coping 2) building a sense of community, and 3) the value of a customizable experience. CONCLUSIONS Female trainees who participated in a group coaching program expressed that they found value in learning how to cope with stressors through metacognition-focused coaching. They also described that building a community and being able to customize the experience were positive aspects of the program. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05280964 . Date of registration: March 15th 2022. Retrospectively registered. URL of trial registry record.
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Affiliation(s)
- Adrienne Mann
- Department of Medicine, Division of Hospital Medicine, University of Colorado Anschutz Medical Campus, Veterans Health Administration, Aurora, CO, USA.
- Rocky Mountain Regional VA Medical Center, 1700 N Wheeling St., Aurora, CO, 80045, USA.
| | - Tyra Fainstad
- Department of Medicine, Division of General Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
- Lowry Internal Medicine, 8101 E Lowry Blvd Ste 120, Denver, CO, 80230, USA.
| | - Pari Shah
- Graduate School of Social Work, University of Denver, Denver, CO, USA
| | - Nathalie Dieujuste
- Adult & Child Consortium for Health Outcomes Research & Delivery Science (ACCORDS), University of Colorado, School of Medicine, Aurora, CO, USA
| | - Kerri Thurmon
- Department of Surgery, Division of Urology, Denver Health, Denver, USA
| | - Kimiko Dunbar
- Department of Pediatrics, Division of Hospital Medicine, Children's Hospital, Aurora, USA
| | - Christine Jones
- Department of Medicine, Division of Hospital Medicine, University of Colorado Anschutz Medical Campus, Veterans Health Administration, Aurora, CO, USA
- Veterans Health Administration, Eastern CO Health Care System, Denver-Seattle Center of Innovation for Veteran-Centered and Value Driven Care, Aurora, CO, USA
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Fainstad T, Mann A, Suresh K, Shah P, Dieujuste N, Thurmon K, Jones CD. Effect of a Novel Online Group-Coaching Program to Reduce Burnout in Female Resident Physicians: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e2210752. [PMID: 35522281 PMCID: PMC9077483 DOI: 10.1001/jamanetworkopen.2022.10752] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
IMPORTANCE Female resident physicians are disproportionately affected by burnout, which can have serious consequences for their well-being and career trajectory. Growing evidence supports the use of professional coaching to reduce burnout in resident physicians, yet individual coaching is resource intensive and infeasible for many training programs. OBJECTIVE To assess whether a structured professional group-coaching program for female resident physicians would lead to decreased burnout. DESIGN, SETTING, AND PARTICIPANTS This pilot randomized clinical trial was conducted from January 1 to June 30, 2021, among 101 female resident physicians in graduate medical education at the University of Colorado who voluntarily enrolled in the trial after a recruitment period. Surveys were administered to participants before and after the intervention. INTERVENTION With the use of a computer-generated 1:1 algorithm, 50 participants were randomly assigned to the intervention group and 51 participants were randomly assigned to the control group. The intervention group was offered a 6-month, web-based group-coaching program, Better Together Physician Coaching, developed and facilitated by trained life coaches and physicians. The control group received residency training as usual, with no coaching during the study. The control group was offered the 6-month coaching program after study completion. MAIN OUTCOMES AND MEASURES The primary outcome of burnout was measured using the Maslach Burnout Inventory, defined by 3 Likert-type 7-point subscales: emotional exhaustion, depersonalization, and professional accomplishment. Higher scores on the emotional exhaustion and depersonalization subscales and lower scores on the professional accomplishment subscale indicate higher burnout. Secondary outcomes of impostor syndrome, self-compassion, and moral injury were assessed using the Young Impostor Syndrome Scale, Neff's Self-Compassion Scale-Short Form, and the Moral Injury Symptom Scale-Healthcare Professionals, respectively. An intention-to-treat analysis was performed. RESULTS Among the 101 female residents in the study, the mean (SD) age was 29.4 (2.3) years, 96 (95.0%) identified as heterosexual, and 81 (80.2%) identified as White. There were 19 residents (18.8%) from surgical subspecialties, with a range of training levels represented. After 6 months of professional coaching, emotional exhaustion decreased in the intervention group by a mean (SE) of 3.26 (1.25) points compared with a mean (SE) increase of 1.07 (1.12) points in the control group by the end of the study (P = .01). The intervention group experienced a significant reduction in presence of impostor syndrome compared with controls (mean [SE], -1.16 [0.31] vs 0.11 [0.27] points; P = .003). Self-compassion scores increased in the intervention group by a mean (SE) of 5.55 (0.89) points compared with a mean (SE) reduction of 1.32 (0.80) points in the control group (P < .001). No statistically significant differences in depersonalization, professional accomplishment, or moral injury scores were observed. Owing to the differential follow-up response rates in the treatment groups (88.2% in the control group [45 of 51]; 68.0% in the intervention group [34 of 50]), a sensitivity analysis was performed to account for the missing outcomes, with similar findings. CONCLUSIONS AND RELEVANCE In this randomized clinical trial, professional coaching reduced emotional exhaustion and impostor syndrome scores and increased self-compassion scores among female resident physicians. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05280964.
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Affiliation(s)
- Tyra Fainstad
- Division of General Internal Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora
- Lowry Internal Medicine, Denver, Colorado
| | - Adrienne Mann
- Division of Hospital Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora
- Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado
| | - Krithika Suresh
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado, School of Medicine, Aurora
| | - Pari Shah
- Graduate School of Social Work, University of Denver, Denver, Colorado
| | - Nathalie Dieujuste
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado, School of Medicine, Aurora
| | - Kerri Thurmon
- Division of Urology, Department of Surgery, Denver Health, Denver, Colorado
| | - Christine D. Jones
- Division of Hospital Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora
- Veterans’ Health Administration, Eastern Colorado Health Care System, Denver-Seattle Center of Innovation for Veteran-Centered and Value Driven Care, Aurora
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