DOI: 10.5061/dryad.n8pk0p2vv
title: Using nominal group technique among resident physicians to identify key attributes of a burnout prevention program

description: Purpose: To identify preferred burnout interventions within a resident
 physician population, utilizing the Nominal Group Technique. The results
 will be used to design a discrete choice experiment study to inform the
 development of resident burnout prevention programs. Methods: Three
 resident focus groups met (10-14 participants/group) to prioritize a list
 of 23 factors for burnout prevention programs. The Nominal Group Technique
 consisted of three steps: an individual, confidential ranking of the 23
 factors by importance from 1 to 23, a group discussion of each attribute,
 including a group review of the rankings, and an opportunity to alter the
 original ranking across participants. Results: The total number of
 residents (36) were a representative sample of specialty, year of
 residency, and sex. There was strong agreement about the most highly rated
 attributes which grouped naturally into themes of autonomy, meaning,
 competency and relatedness. There was also disagreement on several of the
 attributes that is likely due to the differences in residency specialty
 and subsequently rotation requirements. Conclusion: This study identified
 the need to address multiple organizational factors that may lead to
 physician burnout. There is a clear need for complex interventions that
 target systemic and program level factors rather than focus on individual
 interventions. These results may help residency program directors
 understand the specific attributes of a burnout prevention program valued
 by residents. Aligning burnout interventions with resident preferences
 could improve the efficacy of burnout prevention programs by improving
 adoption of, and satisfaction with, these programs.
description: Focus group discussions were audio-recorded and uploaded to a
 secure server for storage. Audio files were transcribed and deidentified.
 Deidentification involved removing participant names. Research team
 reviewed transcripts for quality (i.e. accuracy) and confidentiality
 (i.e., deidentification). We used a 6-step thematic analysis approach to
 capture the diversity and depth of the data relating to the reasons
 underpinning the ranking of outcomes. For step 1, we familiarized
 ourselves with the transcripts. For step 2, we confirmed the selection of
 codes and themes and made necessary amendments to reach a consensus.
 Initial coding was performed in Atlas.ti based on the deductive coding
 framework, with varied responses interpreted inductively into new codes as
 needed. Codes were matched between authors to ensure consistency and
 confirm the definition of the full set of themes. In step 3, we clustered
 nodes into a common theme based on coherent patterns. We used some of the
 quotes in the Results section to demonstrate the legitimacy of the defined
 themes. For step 4, we reduced the themes into the most prevalent implicit
 and explicit ideas while deleting redundant themes. In step 5, we
 described the names and parameters of the identified themes. For step 6,
 we reported the analysis performed.
description: See attached Figures 1 & 2, and ReadMe file for
 additional information.