Burnout, Professional
Conditions
Brief summary
A randomized trial of an interprofessional intervention to reduce burnout and enhance professional engagement in physicians, certified nurse midwives, and nurse practitioners.
Detailed description
To test the hypothesis that an intervention involving self-facilitated interprofessional group meetings would result in improvement in wellbeing and to determine whether use of a written curriculum provided increased benefit, the following study is conducted: Practicing clinical faculty in the Department of Obstetrics and Gynecology at the Massachusetts General Hospital were recruited to participate in three monthly small groups over dinner. Participants were randomized to a control group, which met without any specified guidelines for discussion content, or to receive an intervention which consisted of a one-page discussion guide addressing themes relevant to challenges in the healthcare environment: reframing challenging patient interactions; embracing uncertainty in work; and coping with errors, near misses, and bad outcomes. Outcomes included burnout, empowerment and engagement in work, stress from uncertainty assessed using validated metrics, and perception of of collegiality and community. All participants were also offered the option of participating in evaluation of biomarkers. To test the hypothesis that an increased sense of bonding and relational connection, and reduced stress levels would be reflected by changes in hormone levels during the meeting and over the course of the study. Faculty who opted into this portion of the study gave the following samples: Urine Oxytocin before and after the first and third group meetings Salivary Oxytocin before and after the first and third group meetings Salivary Cortisol before and after the first and third group meetings Hair Cortisol at the beginning of the study and at the end of the study (a roughly three month interval). An optional focus group was conducted after the three monthly sessions. All participants signed a consent form prior to participating in the study.
Interventions
OTHERDiscussion Guide
Written list of prompts to facilitate discussion
Sponsors
Massachusetts General Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* Physican in the Department of Obstetrics and Gynecology at Massachusetts General Hospital * Nurse Practitioner in the Department of Obstetrics and Gynecology at Massachusetts General Hospital * Certified Nurse Midwife in the Department of Obstetrics and Gynecology at Massachusetts General Hospital
Exclusion criteria
* None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Burnout | Change over the three month study period. Baseline measurement and immediately after final intervention. | Change from baseline in 2 item Maslach Burnout Inventory scores before and after the intervention. Minimum score: 2; Maximum score: 14 Higher score = more burnt out (worse outcome) |
| Stress from Uncertainty | Change over the three month study period. Baseline measurement and immediately after final intervention. | Change in scores on Physician Response to Uncertainty Scale before and after intervention Minimum score: 6; Maximum score: 90 Higher score = increased stress due to uncertainty (worse outcome) |
| Work Engagement | Change over the three month study period. Baseline measurement and immediately after final intervention. | Change in scores on Utrecht Work Engagement Scale before and after intervention Minimum score: 0; Maximum score: 54 Higher score = higher engagement at work (better outcome) |
| Urine oxytocin | Two samples were taken one hour apart at baseline, and this was repeated three months later. | Change from baseline in the level of urine oxytocin before and after each intervention. This is an exploratory study so the maximum and minimum values are not known, and any change up or down is interesting. |
| Salivary Oxytocin | Two samples were taken one hour apart at baseline, and this was repeated three months later | Change from baseline in the level of salivary oxytocin before and after each intervention. This is an exploratory study so the maximum and minimum values are not known, and any change up or down is interesting. |
| Salivary Cortisol | Two samples were taken one hour apart at baseline, and this was repeated three months later | Change from baseline in the level of salivary cortisol before and after each intervention. This is an exploratory study so the maximum and minimum values are not known, and any change up or down is interesting. |
| Hair Cortisol | Change over the three month study period. Baseline measurement and immediately after final intervention. | Change from baseline in hair cortisol levels. Maximum and minimum levels are not known and any change up or down is interesting. |
| Work Empowerment Scale | Change over the three month study period. Baseline measurement and immediately after final intervention. | Minimum score: 12; Maximum score: 84 Change from baseline on Work Empowerment Scale before and after intervention. Higher score = higher empowerment at work (better outcome) |
Countries
United States
Outcome results
None listed