Burnout Preventions, Professionalism Heightening, and Enhancing Resiliency (BUPHER)

Study Overview
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Brief Summary
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Due to their difficult and stressful work surgeons are under continuous physical and mental stress exposing them to increased risk for burnout and lack of professionalism. The present intervention focuses on providing time and a safe space to debrief and explore personal and group experiences and dilemmas, as well as acquire coping skills related to burnout, communication and professionalism.

Official Title
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Values and Virtues in Medical Practice: Quasi-Experimental Intervention for Burnout Preventions, Professionalism Heightening, and Enhancing Resiliency (BUPHER) in a Hospital Surgical Division

Conditions
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Professional-Patient Relations, Burnout, Professional

Intervention / Treatment
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* Other: Preventing Professionals burnout


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All physicians (residents and experts) of the Surgical Division at Tel Aviv Sourasky Medical Center. All medical students studying at the Sackler Faculty of Medicine, Tel Aviv University, and attending a surgery round at the Surgical Division at Tel Aviv Sourasky Medical Center. Patients (and/or family members) in the Surgical Division at Tel Aviv Sourasky Medical Center following their surgery. Exclusion Criteria: The research will not include children and/or judgment-impaired patients; population not met by inclusion criteria; non-Hebrew speaking patients; ventilated patients; patients in surgical intensive care; patients medically defined as suffering from clouding of conscious or delirium; subjects who decided to stop their participation in the study.

Ages Eligible for Study
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Minimum Age: 18 Years

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: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Structured group intervention<br>Experimental: Structured group intervention a 'structured' intervention, leaning mostly on tools designed to prevent burnout and promote resilience, including predetermined exercises and topics as discussion goals in each meeting. Fidelity will be checked and monitored at the end of each meeting, when facilitators fill out a form that summarizes the content, topics and coping skills acquired in each session. | Other: Preventing Professionals burnout<br> <br> * Other names: Enhancing professional professional conduct;|
| Experimental: Semi-Structured group intervention<br>Experimental: Semi-Structured group intervention a 'semi-structured' intervention, based on tools for developing an emotional discourse, building a supporting team and self reflection. The 'semi-structured' intervention offers predetermined contents that are discussed through the stories and needs presented by group members. Fidelity will be checked and monitored at the end of each meeting, when facilitators fill out a form that summarizes the content, topics and coping skills acquired in each session. | Other: Preventing Professionals burnout<br> <br> * Other names: Enhancing professional professional conduct;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Professionalism Culture Scale | 12 item scale developed by the American Board of Internal Medicine, by (DeLisa, Foye, Jain, Kirshblum, & Christodoulou, 2001 | Change (increase) from baseline to short and long term measurements (after one year, 3 years, respectively) | 
| Abbreviated Burnout Scale | Nine item scale focused on 3 burnout factors (Iverson, Olekalns & Erwin, 1998) | Change (decrease) from baseline to short and long term measurements (after one year, 3 years, respectively) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Adapted Professionalism Mini-Evaluation Scale Exercise scale | originally included 24 items developed by Cruess, McIlroy, Cruess, Ginsburg, and Steinert (2006). Translated and adapted by the research team, and now include 31 items. | Change (increase) from baseline to short and long term measurements (after one year, 3 years, respectively) | 
| Cynicism in Medicine Questionnaire (CMQ) | 14 item questionnaire developed by Teserman, Morton, Loo, Worthle & Lamberton, 1996 | Change (decrease) from baseline to short and long term measurements (after one year, 3 years, respectively) | 
| Moral & Cognitive Courage Scale | A newly developed questionnaire focused on self efficacy to intervene when a physician acts immorally and actual experience with acting in such cases. | Change (increase) from baseline to short and long term measurements (after one year, 3 years, respectively) | 
| Jefferson Health Professionals Empathy Scale | 20 items questionnaire developed by Hojat, Mangione, Nasca, Cohen, Gonnella, Erdmann & Magee, 2001 | Change (increase) from baseline to short and long term measurements (after one year, 3 years, respectively) | 
| The Areas of Work life Scale (AWS) | 29 items questionnaire developed by Leiter & Maslach, 2004 to measure 6 factors related to work load, control, appreciation, community, fairness and values | Change (increase in balance) from baseline to short and long term measurements (after one year, 3 years, respectively) | 
| Professionals Self Care Practices questionnaire | 43 items comprised from two questionnaires focused on different aspects of self care (Teng, Yen & Fetzer & Shananfelt et al., 2005). the combination of these two questionnaires was assessed by Karnieli-Miller & Michael. | Change (increase) from baseline to short and long term measurements (after one year, 3 years, respectively) | 
| Life satisfaction questionnaire | 3 item questionnaire focused on general life satisfaction. | Change (increase) from baseline to short and long term measurements (after one year, 3 years, respectively) | 
| Perceived Stress Scale (PSS) | 10 item scale focused on perceived stress in the clinics (4 items validated in Ben-Zur & Michael) and 6 items developed by the research team to assess concern and fear from medical mistakes and hierarchy. | Change (decrease) from baseline to short and long term measurements (after one year, 3 years, respectively) | 
| Work-Life Balance | 6 item questionnaire developed by Greenhaus & Powell, 2006) | Change (increase) from baseline to short and long term measurements (after one year, 3 years, respectively) | 
| Resilient Coping Questionnaire (RCQ) | 24 items questionnaire developed by Wolmer, Hamiel & Laor (2105) | Change (increase) from baseline to short and long term measurements (after one year, 3 years, respectively) | 
| Specific Life Satisfaction Questionnaire | 12 items questionnaire developed by Karnieli-Miller & Michael to measure satisfaction with different life domains (e.g., relationships, financial etc). | Change (increase) from baseline to short and long term measurements (after one year, 3 years, respectively) | 
| Brief Resilience Scale (BRS) | 6 item questionnaire developed by Smith et al., 2008 | Change (increase) from baseline to short and long term measurements (after one year, 3 years, respectively) | 
| Patient Satisfaction questionnaire | 23 items questionnaire focused on patient-physician communication skills and satisfaction from care. | Change (increase) from baseline to short and long term measurements (after one year, 3 years, respectively) | 
| Physician Transcendence Scale (PTS) | A 16 items newly developed questionnaire focused on the physicians' transcendence. Laor, Wolmer & Hamiel | Baseline | 
| Demographic information questions | questions concerning gender, age, seniority, specialty, country of birth, | Baseline | 
| Life Events Scale | Assessing life events the individual experienced, such as divorce, a death of a loved one, etc. | Baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Professionalism, Burnout prevention, Resiliency, Student education