Clinical trial NCT05822375: Better Together Physician Coaching: Mitigating Burnout in UME
Official title: Better Together Physician Coaching: Mitigating Burnout in Undergraduate Medical Education
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Burnout, Professional
Lead sponsor: University of Colorado, Denver
Sponsor class: OTHER
First posted: 2023-04-20
Enrollment: 490
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: SEQUENTIAL
Intervention model description: This is a randomized controlled trial. All enrolled participants will complete the pretest baseline survey. After baseline data collection is completed, the participants will be randomized into either a control or intervention group. This randomized controlled trial study design will offer the BT coaching to the intervention group for the duration of 4-months (February 1st 2023- May 31st 2023) and to the control group for the duration of 4-months (September 1st 2023 - December 31st 2023).

At two different timepoints, all participants will be offered surveys containing the following validated indices: burnout, imposter syndrome, self-compassion, moral injury, loneliness, and flourishing. All participants will be offered the survey at baseline- September 2023 (T0), post intervention- January 2024 (T1).
Primary purpose: PREVENTION

Brief summary: Better Together Physician Coaching ("Better Together", or "BT"), a 4-month, web-based positive psychology multimodal coaching program was built to decrease burnout in medical trainees. Here, the investigators seek to understand it's efficacy in University of Colorado School of Medicine (CU SOM) clinicians

Aim 1: Implement Better Together in undergraduate medical education settings for medical students Aim 2: Assess outcomes: primary: reduce burnout as measured by the Maslach Burnout Index (goal: 10% relative improvement), and secondary: self-compassion, imposter syndrome, flourishing, loneliness, and moral injury.

Aim 3: Advance the field of coaching for clinicians through innovation and dissemination of evidence-based approaches to medical student wellbeing.

Detailed description: 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. 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 4-month coaching program for 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). In 2021, the investigators studied BT in a group of female-identifying resident trainees at CU and found that the program significantly improved burnout, imposter syndrome, and self-compassion. This finding supports previous data that life coaching is effective for physicians and physicians in training. The investigators initially focused on women since burnout affects women to a greater degree than their male counterparts, and may have long-lasting consequences on their careers, contributing to a "leaky pipeline" effect. The pilot randomized controlled trial (RCT) of 101 BT women participants demonstrated a statistically significant improvement in burnout, self-compassion, and imposter syndrome in the intervention group.

The investigators now seek to understand if the coaching program is also effective in medical students of all gender identities.

The hypothesis is that Better Together Physician Coaching ("Better Together", or "BT"), a 4-month, web-based positive psychology multimodal coaching program will result in decreased burnout in medical students.

Aim 1: Implement Better Together in the undergraduate medical student population

Aim 2: Assess outcomes: primary: reduce burnout as measured by the Maslach Burnout Index (goal: 10% relative improvement), and secondary: self-compassion, imposter syndrome, flourishing, loneliness, and moral injury.

Aim 3: Advance the field of coaching for clinicians through innovation and dissemination of evidence-based approaches to medical student wellbeing.

Eligibility criteria: Inclusion Criteria:

* current medical students at one of the 5 US undergraduate medical education sites

Exclusion Criteria:

* non-medical students

Primary outcomes:
measure: Burnout as defined by the Maslach Burnout Inventory (MBI): Change from pre to post test
timeFrame: Time Frame: pretest will occur prior to the intervention and posttest will occur after the 4-month intervention.
Secondary outcomes:
measure: Self-Compassion as defined by Neff's Self Compassion Score Short Form (SCS-SF): Change from pre to post test
timeFrame: pretest will occur prior to the intervention and posttest will occur after the 4-month intervention
measure: Moral Injury as defined by the Moral Injury Symptom Scale for Health Professions (MISS-HP) Change from pre to post test
timeFrame: Time Frame: pretest will occur prior to the intervention and posttest will occur after the 4-month intervention
measure: Imposter Syndrome as defined by Young's Imposter Syndrome Symptoms Scale (YISS): Change from pre to post test
timeFrame: pretest will occur prior to the intervention and posttest will occur after the 4-month intervention
measure: Flourishing as defined by the Secure Flourish Index (SFI): Change from pre to post test
timeFrame: pretest will occur prior to the intervention and posttest will occur after the 4-month intervention
measure: Loneliness as defined by the UCLA 3-item Loneliness Scale: Change from pre to post test
timeFrame: pretest will occur prior to the intervention and posttest will occur after the 4-month intervention
Other outcomes:
Locations:
city: Aurora
country: United States
facility: University of Colorado School of Medicine
state: Colorado
Study officials:
References:
citation: Villwock JA, Sobin LB, Koester LA, Harris TM. Impostor syndrome and burnout among American medical students: a pilot study. Int J Med Educ. 2016 Oct 31;7:364-369. doi: 10.5116/ijme.5801.eac4. Mantri S, Lawson JM, Wang Z, Koenig HG. Identifying Moral Injury in Healthcare Professionals: The Moral Injury Symptom Scale-HP. J Relig Health. 2020 Oct;59(5):2323-2340. doi: 10.1007/s10943-020-01065-w. Kelly-Hedrick M, Rodriguez MM, Ruble AE, Wright SM, Chisolm MS. Measuring Flourishing Among Internal Medicine and Psychiatry Residents. J Grad Med Educ. 2020 Jun;12(3):312-319. doi: 10.4300/JGME-D-19-00793.1. 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 May 2;5(5):e2210752. doi: 10.1001/jamanetworkopen.2022.10752. Erratum In: JAMA Netw Open. 2022 Jun 1;5(6):e2220348. Maslach, C., Jackson, S. E., & Leiter, M. P. (1997). Maslach Burnout Inventory: Third edition. In C. P. Zalaquett & R. J. Wood (Eds.), Evaluating stress: A book of resources (pp. 191-218). Scarecrow Education. Neff KD. Self-Compassion Scale. PsycTESTS Dataset. 2012. doi:10.1037/t10178-000 Hughes ME, Waite LJ, Hawkley LC, Cacioppo JT. A Short Scale for Measuring Loneliness in Large Surveys: Results From Two Population-Based Studies. Res Aging. 2004;26(6):655-672. doi: 10.1177/0164027504268574.