The Impact of a Novel Coaching Program on Medical Errors and Well-Being of Physicians

Study Overview
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Brief Summary
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This is a randomized controlled trial with a mixed method design to determine the impact of coaching on self-perceived medical errors, burnout, and resilience. The study team developed a novel coaching curriculum based in principles of positive psychology and self-reflection with the hypothesis that the coaching intervention will lead to decreased medical errors, decreased burnout, and increased resilience in trainee and faculty participants. Resident and fellow trainees as well as faculty members were recruited across departments and randomized to coaching or control. Faculty in the coaching arm were trained in coaching techniques and paired with a trainee coachee. Survey results as well as focus groups will be used to analyze the impact of the coaching program as compared to standard mentorship (control).

Official Title
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A Randomized Controlled Trial on The Impact of a Novel Coaching Program on Medical Errors, Clinical Reasoning, and Well-Being of Physicians, or the CARE (Coaching to Advance Resilience and Reduce Error) Study

Conditions
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Burnout, Adverse Event, Medical Education

Intervention / Treatment
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* Behavioral: Coaching


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Residents and fellows in a training program at Beth Israel Deaconess Medical Center (BIDMC) faculty members at BIDMC
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Trainees - treatment<br>Residents and fellows paired with a faculty coach from the faculty - treatment arm to participate in up to 4 coaching meetings | Behavioral: Coaching<br>* A novel coaching curriculum based in positive psychology with an emphasis on self-reflection, goal setting and adverse event processing.<br>|
| No Intervention: Trainees - control<br>Residents and fellows randomized to the control arm. They are not paired with a faculty coach and instead continue to receive standard mentorship as part of their training program. | |
| Experimental: Faculty - treatment<br>Faculty members randomized to receive coaching training and are paired with a resident/fellow from the trainees - treatment arm to conduct up to 4 coaching sessions over the course of the academic year. | Behavioral: Coaching<br>* A novel coaching curriculum based in positive psychology with an emphasis on self-reflection, goal setting and adverse event processing.<br>|
| No Intervention: Faculty - control<br>Faculty members randomized to control arm. They are not paired with a trainee from this study and instead continue to provide mentorship as they typically would, as part of their role at an academic medical center | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Medical errors in trainees | Self-perceived medical errors amongst trainees based on survey response. | baseline (pre) compared to results at the end (post) of the coaching intervention, an average of 9 months | 
| Burnout | Burnout score amongst trainees and faculty based on Stanford Professional Fulfillment Index | baseline (pre) compared to results at the end (post) of the coaching intervention, an average of 9 months | 
| Resilience | Burnout score amongst trainees and faculty based on Connor Davidson Resilience Scale 2 | baseline (pre) compared to results at the end (post) of the coaching intervention, an average of 9 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| medical errors in faculty | Self-perceived medical errors amongst faculty based on survey response. Specifically, faculty are asked Do you think you may have made any medical error in the last 3 months? A medical error is the failure of a planned action to be completed as intended, or the failure of an unplanned action that should have been completed with answer choices yes, no, and unsure. | baseline (pre) compared to results at the end (post) of the coaching intervention, an average of 9 months | 
| delayed medical errors in faculty | Self-perceived medical errors amongst faculty based on survey response | baseline (beginning of study, before intervention) compared to 6 months post coaching program | 
| Mechanism of change | Mechanism of change in burnout, resilience and medical errors in both trainees and faculty as compared to standard mentorship | assessed an average of 1 year after intervention initiation | 
| Delayed Medical errors in trainees | Self-perceived medical errors amongst trainees based on survey response | up to 15 months | 
| Burnout | Burnout score amongst trainees and faculty based on Stanford Professional Fulfillment Index | baseline (beginning of study, before intervention) compared to 6 months post coaching program | 
| Delayed Resilience | Burnout score amongst trainees and faculty based on Connor-Davidson-RISC2 | baseline (beginning of study, before intervention) compared to 6 months post coaching program | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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burnout, Coaching, wellness, medical errors