Burnout
Conditions
Keywords
wellness coaching, performance coaching, biometric feedback, psychological stress
Brief summary
Medical students often begin training with psychological and physiological health metrics superior to their age-matched peers. By graduation, however, rates of depression, anxiety, and physiologic dysregulation are markedly higher, reflecting the cumulative strain of long study hours, high-stakes examinations, and the emotional burden of early patient care. Despite this, few medical schools provide structured, evidence-based tools for students to develop resiliency and recovery skills before clinical rotations begin.
Detailed description
This gap represents both a health crisis and an educational opportunity. Burnout originating in medical school often persists into residency and practice, diminishing empathy and professionalism, and contributing to long-term attrition. Existing wellness offerings are largely reactive, relying on voluntary counseling or broad wellness sessions that fail to provide individualized insight into students' physiological readiness or stress recovery capacity. Moreover, schools lack objective, continuous data to pinpoint when students are physiologically stressed to tailor timely support. Against this backdrop, this study proposes evaluating a structured performance coaching and biometric feedback approach in the context of scheduled academic stressors. Arena Strive is a digital coaching platform that integrates a virtual human performance coach, wearable-derived biometric data, and a focused skills curriculum adapted from other high-stress domains and tailored to frontline healthcare workers. This novel intervention has proven effective in significantly reducing burnout and enhancing professional fulfillment and self-valuation in a large health-system through an 8-week intervention.
Interventions
BEHAVIORALArena Strive
integrates asynchronous coaching, two virtual coaching sessions with a high-performance medicine coach, physiological data from wearable sensors, and a focused curriculum of performance tools tailored to frontline healthcare workers.
Sponsors
Wake Forest University Health Sciences
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
first-year medical students from Wake Forest School of Medicine
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
* active first year Wake Forest School of Medicine medical students * have an Android or iOS smart phone * are willing to download the Arena Strive application
Exclusion criteria
* under the age of 18; or over the age of 60 * pregnant at enrollment or during course of study * any self-reported cardiac conditions that may impact heart rate and heart rate variability
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Heart Rate Variability | Weekly through Week 13 | Mean daily nocturnal Heart Rate Variability (HRV): Higher = Better |
| Resting Heart Rate (Beats per Minute) | Weekly through Week 13 | daily nocturnal Resting Heart Rate (RHR): Lower = Better |
| Sleep Duration (minutes) | Weekly through Week 13 | Mean nightly sleep: Higher = Better |
| Sleep Consistency (minutes) | Weekly through Week 13 | SD of mid-sleep time: Lower = Better |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Perceived Stress (Perceived Stress Scale PSS-4) Scores | Weekly through Week 13 | To score the Perceived Stress Scale 4 (PSS-4), first, reverse the scores for questions 2 and 3 (0 becomes 4, 1 becomes 3, 2 stays 2, 3 becomes 1, and 4 becomes 0). Then, add up the scores for all four questions. The total score will range from 0 to 16, with higher scores indicating greater perceived stress. |
| Change in Burnout (Maslach Burnout Inventory MBI-GSS) Scores | Week 13 | MBI-GSS scoring involves summing responses for each of its three subscales: emotional exhaustion, cynicism, and professional efficacy, which are rated on a 7-point frequency scale from 0 (never) to 6 (daily). To determine burnout, high scores on exhaustion and cynicism indicate higher burnout, while low scores on professional efficacy suggest greater burnout. These subscale scores are then interpreted separately to understand the level of burnout for each dimension. Each item is rated on a frequency scale (e.g., 0 to 6), and higher or lower scores on each subscale indicate different levels of burnout. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORDermot Phelan, MD, PhD
Wake Forest University Health Sciences
Outcome results
None listed