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Better Together Physician Coaching: An Innovative Solution to Medical Trainee Burnout

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT05222685
Recruitment Status : Completed
First Posted : February 3, 2022
Last Update Posted : September 28, 2023
Sponsor:
Information provided by (Responsible Party):
University of Colorado, Denver

Brief Summary:

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. Women and those underrepresented in medicine (URM) experience a disproportionate amount of burnout likely due to the cognitive load required to manage microaggressions, stereotypes, and harmful socially adopted narratives around efficacy. 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 6-month coaching program for women residents 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). A pilot randomized controlled trial (RCT) of 101 BT participants demonstrated a statistically significant improvement in burnout, self-compassion, and imposter syndrome in the intervention group. BT will be scaled up to a national level and evaluated with an RCT mirroring our pilot in 10+ graduate medical education (GME) programs for 1000+ participants coordinated and evaluated by our CU team.

To accomplish this goal, the investigators set the following major objectives for this project:

  • Prepare to expand the BT program by teaming with a cohort of diverse physician coaches.
  • Implement BT in 10+ GME programs to serve 1000+ trainee participants with deliberate inclusion of institutions with diverse GME trainee populations serving geographically rural and/or medically underserved areas.
  • Assess our outcomes: primary: reduce burnout as measured by the Maslach Burnout Index (goal: 10% relative improvement), and secondary: self-compassion, imposter syndrome and moral injury. Outcome generalizability and program feasibility at a national level will also be analyzed, as will participant experience to gain a richer understanding of how BT may help trainees, in particular those URM.
  • Advance the field of coaching in GME through innovation and dissemination of evidence-based approaches to GME trainee wellbeing.

Condition or disease Intervention/treatment Phase
Burnout, Professional Behavioral: Better Together Physician Coaching Not Applicable

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 1017 participants
Allocation: Randomized
Intervention Model: Sequential Assignment
Intervention Model Description: This randomized controlled trial will offer the intervention group the intervention of BT coaching during the first 6-months while the control group, or "waitlist group" will receive no intervention aside from the usual wellness activities of their institution.
Masking: None (Open Label)
Primary Purpose: Prevention
Official Title: Better Together Physician Coaching: An Innovative Solution to Medical Trainee Burnout
Actual Study Start Date : September 1, 2022
Actual Primary Completion Date : September 1, 2023
Actual Study Completion Date : September 1, 2023

Arm Intervention/treatment
Experimental: Intervention Group
Will receive the 6 month online group coaching program from 9/1/2022-3/1/23
Behavioral: Better Together Physician Coaching
Professional group coaching for medical trainees. A 6 month, online, group, positive psychology based coaching program for wellness.

No Intervention: Control Group

Control group - no coaching intervention from 9/1/2022-3/1/23.

(They will receive the coaching intervention after study completion from 3/1/23-9/1/23)




Primary Outcome Measures :
  1. Burnout as defined by the Maslach Burnout Inventory (MBI) [ Time Frame: pretest will occur prior to the intervention and post test will occur after the 6 month intervention. A post-post test will occur 6 and 12 months after the intervention is done. ]
    The Maslach burnout inventory (MBI) is a 22-item measurement of worker burnout which assesses emotional exhaustion (EE), depersonalization (DP), and personal fulfillment (PF) domains. Possible scores range from 0-6 on a Likert scale for each item. Scores of EE ≥ 27 points, DP ≥ 10, and PF <33 would indicate a high degree of burnout. Scores of EE≤18 points, DP≤5 points, and PF≥40 points would indicate a low degree of burnout.


Secondary Outcome Measures :
  1. Self-Compassion as defined by Neff's Self Compassion Score Short Form (SCS-SF) [ Time Frame: pretest will occur prior to the intervention and post test will occur after the 6 month intervention. A post-post test will occur 6 and 12 months after the intervention is done. ]
    Neff's Self Compassion Score Short Form (SCS-SF) is a 12-item measurement of self compassion. Possible scores range from 0-6 on a Likert scale for each item, where the higher scale scores indicate greater self-compassion. Scores of 1.0- 2.49 are considered to be low, between 2.5-3.5 to be moderate, and 3.51-5.0 to be high.


Other Outcome Measures:
  1. Moral Injury as defined by the Moral Injury Symptom Scale for Health Professions (MISS-HP) [ Time Frame: pretest will occur prior to the intervention and post test will occur after the 6 month intervention. A post-post test will occur 6 and 12 months after the intervention is done. ]
    Moral Injury Symptom Scale for Health Professions (MISS-HP) is a 10-item measurement of moral injury. Possible scores range from 0-5 on a Likert scale for each item, where the higher scale scores indicate greater moral injury. Scores >35(on a possible score range of 10 to 100) are considered high for moral injury symptoms causing moderate to extreme problems with family, social, and occupational functioning.

  2. Imposter Syndrome as defined by Young's Imposter Syndrome Symptoms Scale (YISS) [ Time Frame: pretest will occur prior to the intervention and post test will occur after the 6 month intervention. A post-post test will occur 6 and 12 months after the intervention is done. ]
    Young's Imposter Syndrome Symptoms Scale (YISS) is a 8-item measurement of imposter syndrome. Scoring is yes/no where a score of >5/8 is felt to be positive for imposter syndrome.



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   Female
Gender Based Eligibility:   Yes
Gender Eligibility Description:   Medical trainees (residents or fellows) who identify as women, including trans women, as well as those who identify as gender non-conforming, non-binary, and gender queer.
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Medical trainees (residents or fellows)
  • Identify as female (including trans women, as well as those who identify as gender non-conforming, non-binary, and gender-queer).

Exclusion Criteria:

  • Non medical trainees
  • Those who do not identify as female (including trans women, as well as those who identify as gender non-conforming, non-binary, and gender-queer).

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05222685


Locations
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United States, Colorado
University of Colorado
Aurora, Colorado, United States, 80045
Sponsors and Collaborators
University of Colorado, Denver
Investigators
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Principal Investigator: Tyra Fainstad, MD University of Colorado School of Medicine
Publications of Results:

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Responsible Party: University of Colorado, Denver
ClinicalTrials.gov Identifier: NCT05222685    
Other Study ID Numbers: 22-0028
First Posted: February 3, 2022    Key Record Dates
Last Update Posted: September 28, 2023
Last Verified: September 2023
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Plan Description: No sharing.

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Burnout, Professional
Burnout, Psychological
Stress, Psychological
Behavioral Symptoms
Occupational Stress
Occupational Diseases