Dyrbye, Liselotte N.

This study explores US medical students’ intent to practice in underserved areas, analyzed by demographic characteristics.

Introduction Medical students experience higher rates of distress and burnout compared with their age-similar peers overall. Coaching has been proposed as one means of combating distress and burnout within the medical profession. The purpose of this systematic review is to synthesise the current evidence on the effects of coaching interventions on medical student well-being, including engagement, resilience, quality of life, professional fulfilment and meaning in work and distress, including burnout, anxiety and depressive symptoms. Methods and analysis We will conduct a systematic review of interventional and observational comparative studies that assess the effects of coaching interventions on well-being, including engagement, resilience, quality of life, professional fulfilment and meaning in work and distress, including burnout, anxiety and depressive symptoms among undergraduate medical students internationally. We will search PubMed (MEDLINE), Embase (OVID), PsycINFO (OVID), Scopus, ERIC, Cochrane Database of Systematic Reviews (OVID) and Cochrane Central Register of Controlled Trials (OVID) from their respective inception dates using the following search terms: (medical students OR medical student OR undergraduate medical education) AND (coach OR coaching OR coaches). Studies in any language will be eligible. Studies that report one or more outcomes of distress or well-being among medical students who receive a coaching intervention will be included. Data on participant and intervention characteristics, outcomes and instruments used will be collected as well as quality/risk of bias assessments. Two reviewers will screen studies against the inclusion criteria and perform data extraction. We will conduct a narrative synthesis, with meta-analysis if evidence permits quantitative pooling of results. Heterogeneity of results across studies according to study design, learner level and study risk of bias will be evaluated, as well as publication bias. Ethics and dissemination Ethical approval is not required for this review. Results will be disseminated by publication in a scientific journal. PROSPERO registration number CRD42022322503.

Objective: To determine if individualized professional coaching reduces burnout, improves quality of life, and increases resilience among surgeons. Background: Burnout is common among surgeons and associated with suboptimal patient care and personal consequences. Methods: A randomized controlled trial of 80 surgeons evaluating the impact of 6 monthly professional coaching sessions on burnout (Maslach Burnout Inventory), quality of life (single-item linear analog scale), and resilience (Connor-Davidson Resilience Scale) immediately postintervention and 6 months later. Participants randomized to the control group subsequently received 6 professional coaching sessions during months 6 to 12 (delayed intervention). Results: At the conclusion of professional coaching in the immediate intervention group, the rate of overall burnout decreased by 2.5% in the intervention arm compared with an increase of 2.5% in the control arm [delta: −5.0%, 95% confidence interval (CI): −8.6%, −1.4%; P=0.007]. Resilience scores improved by 1.9 points in the intervention arm compared with a decrease of 0.2 points in the control arm (delta: 2.2 points; 95% CI: 0.07, 4.30; P=0.04). Six months after completion of the coaching period, burnout had returned to near baseline levels while resilience continued to improve among the immediate intervention group. The delayed intervention group experienced improvements in burnout during their coaching experience relative to the immediate intervention group during their postintervention period (18.2% decrease vs 2.9% increase, delta: −21.1%, 95% CI: −24.9%, −17.3%; P<0.001). Conclusions: Professional coaching over 6 months improved burnout and resilience among surgeons, with reductions in improvement over the ensuing 6 months.

Abstract Purpose To examine associations of social support and social isolation with burnout, program satisfaction, and organization satisfaction among a large population of U.S. residents and fellows and to identify correlates of social support and social isolation. Method All residents and fellows enrolled in graduate medical education programs at Mayo Clinic sites were surveyed in February 2019. Survey items measured social support (emotional and tangible), social isolation, burnout, program satisfaction, and organization satisfaction. Factors of potential relevance to social support were collected (via the survey, institutional administrative records, and interviews with program coordinators and/or program directors) and categorized as individual, interpersonal, program, or work-related factors (duty hours, call burden, elective time, vacation days used before survey administration, required away rotations, etc.). Multivariable regression analyses were conducted to examine relationships between variables. Results Of 1,146 residents surveyed, 762 (66%) from 58 programs responded. In adjusted models, higher emotional and tangible support were associated with lower odds of burnout and higher odds of program and organization satisfaction, while higher social isolation scores were associated with higher odds of burnout and lower odds of program satisfaction and organization satisfaction. Independent predictors of social support and/or social isolation included age, gender, relationship status, parental status, postgraduate year, site, ratings of the program leadership team, ratings of faculty relationships and faculty professional behaviors, satisfaction with autonomy, and vacation days used before survey administration. Conclusions This study demonstrates that social support and social isolation are strongly related to burnout and satisfaction among residents and fellows. Personal and professional relationships, satisfaction with autonomy, and vacation days are independently associated with social support and/or social isolation, whereas most program and work-related factors are not. Additional studies are needed to determine if social support interventions targeting these factors can improve well-being and enhance satisfaction with training.

Abstract Problem Faculty at academic health centers have many competing demands on their time, leading to high work stress, burnout, and limited capacity to meaningfully improve their teaching, evaluation, feedback, and other education-related skills. Faculty development provides a useful mechanism to assist faculty in enhancing their knowledge and skills in these areas, but engaging faculty can be a challenge. Approach To promote engagement, the authors developed a multipronged, pragmatic approach to faculty development. They created: (1) brief videos leveraging micro-learning strategies; (2) prepackaged workshops for use during existing faculty meetings; (3) a newsletter to raise awareness of faculty development opportunities; (4) a searchable, web-based catalog to facilitate rapid retrieval of faculty development content; and (5) an academy to acknowledge engagement of individual faculty members, provide certificates, and promote a culture that prioritizes our education mission. Outcomes Since they launched the new approach in 2017, they have developed 41 microlearning videos, 15 prepackaged workshops, and 24 issues of the newsletter. Between January 2017 and May 2021, the videos generated more than 150,055 views; the workshops were downloaded 2,850 times; and the issues of the newsletter, emailed bimonthly to 3,500 members of the faculty, had an open rate that increased from 30% in 2017 to 70% in 2021. The Academy of Educational Excellence, which was launched in 2018, grew to more than 490 members. Preliminary feedback suggests faculty and education leaders are highly satisfied with the faculty development resources and approaches to engagement. Next Steps Next steps include obtaining more user satisfaction data and evaluating whether education-related knowledge and skills have improved among faculty participants.