Correlating Burnout and Well-being in a Multisite Study of Internal Medicine Residents and Faculty

Larsen, Dana; Chu, Jacqueline T.; Yu, Liyang; Chang, Yuchiao; Donelan, Karen; Palamara, Kerri

doi:10.1007/s11606-021-06653-4

Cited by 8 publications

(10 citation statements)

References 11 publications

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“…The PERMA scores in our study ranged in the three time points from 54.7 to 57.3, which is lower than the mean PERMA of 154 medicine faculty (60.9) who participated in PDCPs across multiple institutions. This suggests that our faculty in this study had slightly lower PERMA than prior cohorts [11]. We had also hypothesized that professional fulfillment might increase due to participation as a coach.…”

Section: Discussionmentioning

confidence: 76%

“…Lastly, while the trends in burnout and IPD (improving) and well-being on PERMA (worsening) may seem contradictory, it is worth emphasizing that burnout and well-being are not mirror opposite constructs. They capture different elements of a subject's emotional health and recent work by this group has even shown that PERMA and burnout (on the MBI) are not correlated [11].…”

Section: Discussionmentioning

confidence: 99%

“…The PDCP was developed at the senior author's home institution in 2011 through collaboration with the Institute of Coaching, and first implemented with internal medicine interns in 2012 [8]. It has since been expanded to several institutions and organizations with several publications describing the model, approach, and impact [9][10][11]. The research protocol and all research materials and methods were approved by this institution's Institutional Review Board (Protocol #2017P00056).…”

Section: Program Descriptionmentioning

confidence: 99%

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The experience of academic physician coaches in a professional development coaching program

et al. 2022

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Purpose The Professional Development Coaching Program (PDCP) is a physician coaching program founded on the principles of positive psychology that has been shown to improve burnout and well-being in residents. The experience of the physician faculty coaches is not well understood. We studied the impact of a longitudinal coaching intervention on the experience of coaches. Methods From 2017 to 2019, faculty from Surgery, Pediatrics, and Medicine at an academic medical center participated as coaches in the PDCP. Coaches underwent training in positive psychology and coaching skills and coached trainees for one or two years. Surveys were performed at baseline, after 1 year (EOY-1), and after 2 years of coaching (EOY-2). Outcomes include burnout and professional fulfillment (Stanford Professional Fulfillment Index), well-being (PERMA), and experience with coaching skills. Surveys from each timepoint were paired and analyzed through bivariate analyses and multivariate linear regression. Results Of the 136 coaches who participated, 44% submitted sufficient data for paired analysis. There was no change from pre-to post-in primary outcomes on bivariate analysis. On linear regression, burnout and PERMA scores declined from baseline but did not change from EOY-1 to EOY-2. Coaches reported increased coping skills on EOY surveys compared to baseline. Confidence with coping skills was associated with low burnout, high professional fulfillment, and high PERMA. Conclusions These findings create a profile of physician coaches and demonstrate both the benefits and changes in burnout and well-being that they experience. Larger studies with comparison groups can further explore the effects of coaching on the coach.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Program Descriptionmentioning

confidence: 99%

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The experience of academic physician coaches in a professional development coaching program

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“…In particular, gratitude can flip the “disease search pattern” of physicians causing depersonalization by fostering meaningfulness (Restauri et al, 2019 ). The ability to cultivate a sense of meaning in work, also postulated in the PERMA-model, is a critical connection between engagement on the one hand and burnout on the other as meaning might be a defining factor choosing to continue to pursue career goals (Larsen et al, 2021 ). Tailored interventions could also focus on the reflection of virtues in “good doctors” (Arthur et al, 2015 ) or further implement mindfulness-based strengths practice into medical curricula and training of physicians (Niemiec, 2014 ).…”

Section: Discussionmentioning

confidence: 99%

Reality Meets Belief: A Mixed Methods Study on Character Strengths and Well-Being of Hospital Physicians

et al. 2021

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Positive psychology deals with factors that make life most worth living and focuses on enhancing individual potentials. Particularly, character strengths can positively contribute to well-being and work-related health, bearing a promising potential for professions, such as physicians, who are at risk for burnout or mental illnesses. This study aims to identify beneficial character strengths by examining the quantitative and qualitative data. In a cross-sectional multi-method study, 218 hospital physicians completed an online survey assessing their character strengths and their general and work-related well-being, comprising thriving, work engagement, and burnout dimensions (outcome variables). Quantitative data were analyzed for the total sample and by tertiary split. Additionally, interview-gathered opinions of four resident physicians and four medical specialist educators were collected to expand the perspective on which character strengths might be beneficial for the well-being of the resident physicians. The highest significant correlations between character strengths and outcome variables were found for hope and thriving (r = 0.67), zest, and work engagement (r = 0.67) as well as emotional exhaustion (r = −0.47), perseverance/leadership and depersonalization (r = −0.27), bravery, and reduced personal accomplishment (r = −0.39). Tertiary splits revealed that some correlations were not consistent across the entire scale continuum, for example, creativity was only significantly correlated with comparatively high levels of thriving (r = 0.28) or forgiveness with comparatively high levels of depersonalization (r = −0.34). Humility, social intelligence, and teamwork showed predominantly low correlations with all outcome variables (r = −0.17 − 0.34), although humility was stated by all interviewed medical specialist educators to be the most relevant for the well-being at work, and the latter two by three resident physicians, respectively. Different perspectives resulting from quantitative and qualitative data in terms of beneficial character strengths for work-related well-being may be driven by different work experiences, professional understandings, generational beliefs, or social expectations. Some significant correlations between character strengths and well-being outcomes varied depending on low, medium, or high outcomes. This raises questions about suitable work-related well-being interventions, as simple single intervention approaches (one intervention fits all) may not work for the respective outcome levels. These new findings warrant further research on how to foster the well-being of resident physicians at work.

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“…3,[16][17][18][19] While most studies rely on self-reported measures of potential factors (e.g., available time for documentation), 20 EHR log data has more recently been leveraged to quantify time spent on different tasks, 21,22 and to find associations between EHR use measures and burnout. 23,24 While many studies focus on burnout, physician well-being is a broader concept, 4,25,26 encompassing dimensions such as engagement, professional fulfillment, and quality of life dimensions. 27,28 Interventions targeting work environment structural factors have been shown to reduce physician burnout, suggesting the support care team as an important driver of well-being.…”

Section: Introductionmentioning

confidence: 99%

Understanding Physician Work and Well-being Through Social Network Modeling Using Electronic Health Record Data: a Cohort Study

et al. 2022

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Background Understanding association between factors related to clinical work environment and well-being can inform strategies to improve physicians’ work experience. Objective To model and quantify what drivers of work composition, team structure, and dynamics are associated with well-being. Design Utilizing social network modeling, this cohort study of physicians in an academic health center examined inbasket messaging data from 2018 to 2019 to identify work composition, team structure, and dynamics features. Indicators from a survey in 2019 were used as dependent variables to identify factors predictive of well-being. Participants EHR data available for 188 physicians and their care teams from 18 primary care practices; survey data available for 163/188 physicians. Main Measures Area under the receiver operating characteristic curve (AUC) of logistic regression models to predict well-being dependent variables was assessed out-of-sample. Key Results The mean AUC of the model for the dependent variables of emotional exhaustion, vigor, and professional fulfillment was, respectively, 0.665 (SD 0.085), 0.700 (SD 0.082), and 0.669 (SD 0.082). Predictors associated with decreased well-being included physician centrality within support team (OR 3.90, 95% CI 1.28–11.97, P=0.01) and share of messages related to scheduling (OR 1.10, 95% CI 1.03–1.17, P=0.003). Predictors associated with increased well-being included higher number of medical assistants within close support team (OR 0.91, 95% CI 0.83–0.99, P=0.05), nurse-centered message writing practices (OR 0.89, 95% CI 0.83–0.95, P=0.001), and share of messages related to ambiguous diagnosis (OR 0.92, 95% CI 0.87–0.98, P=0.01). Conclusions Through integration of EHR data with social network modeling, the analysis highlights new characteristics of care team structure and dynamics that are associated with physician well-being. This quantitative methodology can be utilized to assess in a refined data-driven way the impact of organizational changes to improve well-being through optimizing team dynamics and work composition.

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Correlating Burnout and Well-being in a Multisite Study of Internal Medicine Residents and Faculty

Cited by 8 publications

References 11 publications

The experience of academic physician coaches in a professional development coaching program

The experience of academic physician coaches in a professional development coaching program

Reality Meets Belief: A Mixed Methods Study on Character Strengths and Well-Being of Hospital Physicians

Understanding Physician Work and Well-being Through Social Network Modeling Using Electronic Health Record Data: a Cohort Study

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