15, 16 Evidence supporting physician coaching is growing, but predominantly describes individual coaching led by nonphysician or noncertified faculty coaches in small studies. 6, 14 Coaching, unlike therapy, does not diagnose or treat, and instead uses inquiry and metacognition (ie, thinking about one’s thinking) to guide self-progress. 10 - Surgeon General’s Advisory emphasized building a culture of well-being in training institutions and included coaching as a recommended tool. Professional coaching is a promising intervention to reduce burnout. 1 - 5 In 2022, the US Surgeon General declared physician burnout a crisis deserving of a multipronged approach to bring about “bold, fundamental change,” 6 yet little is known about scalable, effective interventions to mitigate burnout risk. Physician burnout is highly prevalent in the US is disproportionately experienced by physician trainees and women and is associated with substance abuse, job turnover, higher rates of medical errors, and patient mortality. Trial Registration Identifier: NCT05222685 The sensitivity analysis found similar findings.Ĭonclusions and Relevance The findings of this randomized clinical trial suggest that web-based professional group-coaching can improve outcomes of well-being and mitigate symptoms of burnout for women physician trainees. Flourishing improved by a mean (SE) of 0.48 (0.09) points in the intervention group vs 0.09 (0.07) points in the control group (absolute difference, 0.38 points 95% CI, 0.17 to 0.60 points P < .001). Self-compassion increased by a mean (SE) of 5.27 (0.47) points in the intervention group and by 1.36 (0.36) points in the control group (absolute difference, 3.91 points 95% CI, 2.73 to 5.08 points P < .001). Moral injury decreased by a mean (SE) of −5.60 (0.92) points in the intervention group compared with −0.92 (0.71) points in the control group (absolute difference, −4.68 points 95% CI, −6.95 to −2.41 points P < .001). Impostor syndrome decreased by a mean (SE) of −1.43 (0.14) points in the intervention group compared with −0.15 (0.11) points in the control group (absolute difference, −1.28 (0.18) points 95% CI −1.63 to −0.93 points P < .001). Depersonalization decreased by a mean (SE) of −1.66 (0.42) points in the intervention group compared with a mean (SE) increase of 0.20 (0.32) points in the control group (absolute difference, −1.87 points 95%CI, −2.91 to −0.82 points P < .001). Emotional exhaustion decreased by an estimated mean (SE) −3.81 (0.73) points in the intervention group compared with a mean (SE) increase of 0.32 (0.57) points in the control group (absolute difference, −4.13 points 95% CI, −5.94 to −2.32 points P < .001). Results Among the 1017 women trainees in the study (mean age, 30.8 years 540 White participants 186 surgical trainees ), 502 were randomized to the intervention group and 515 were randomized to the control group. A sensitivity analysis was performed to account for the missing outcomes. A linear mixed model analysis was performed on an intent-to-treat basis. Secondary outcomes included changes in impostor syndrome, moral injury, self-compassion, and flourishing, which were assessed using standardized measures. Main Outcomes and Measures The primary outcomes were change in burnout (measured using subscales for emotional exhaustion, depersonalization, and personal achievement from the Maslach Burnout Inventory). Intervention A 4-month, web-based, group coaching program. Eligible participants included physician trainees at included sites who self-identified as a woman (ie, self-reported their gender identity as woman, including those who reported woman if multiple genders were reported). Objective To assess the generalizability of a coaching program (Better Together Physician Coaching) in a national sample of women physician trainees.ĭesign, Setting, and Participants A randomized clinical trial involving trainees in 26 graduate medical education institutions in 19 states was conducted between September 1, 2022, and December 31, 2022. Professional coaching may improve well-being, but generalizable evidence is lacking. Importance Physician burnout disproportionately affects women physicians and begins in training. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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