Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN.
Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN.
Mayo Clin Proc. 2021 Oct;96(10):2606-2614. doi: 10.1016/j.mayocp.2021.02.028. Epub 2021 Aug 5.
To evaluate physician small groups to promote physician well-being in a scenario with provided discussion topics but without trained facilitators, and for which protected time was not provided but meal expenses were compensated.
We conducted a randomized controlled trial of 125 practicing physicians in the Department of Medicine, Mayo Clinic, Rochester, Minnesota, between October 2013 and October 2014 with subsequent assessment of organizational program implementation. Twelve biweekly self-facilitated discussion groups involving reflection, shared experience, and small-group learning took place over 6 months. Main outcome measures included meaning in work, burnout, symptoms of depression, quality of life, social support, and job satisfaction assessed using validated metrics.
At 6 months after completion of the intervention (12 months from baseline), the rate of overall burnout had decreased by 12.7% (31/62 to 19/51) in the intervention arm versus a 1.9% increase (25/61 to 24/56) in the control arm (P<.001). The rate of depressive symptoms had decreased by 12.8% (29/62 to 17/50) in the intervention arm versus a 1.1% increase (20/61 to 19/56) in the control arm (P<.001). The proportion of physicians endorsing at least moderate self-reported likelihood of leaving their current practice in the subsequent 2 years had decreased by 1.9% (17/62 to 13/51) in the intervention arm and increased by 6.1% (14/61 to 16/55) in the control arm (P<.001). No statistically significant differences were seen in mean changes in burnout scale scores, meaning, or social support, although numeric differences generally favored the intervention.
Self-facilitated physician small-group meetings improved burnout, depressive symptoms, and job satisfaction. This intervention represents a low-cost strategy to promote important dimensions of physician well-being.
clinicaltrials.gov Identifier: NCT04466423.
评估医师小组在提供讨论主题但没有经过培训的主持人的情况下促进医师幸福感的效果，并且不提供受保护的时间，但会补偿餐费。
我们在明尼苏达州罗切斯特市梅奥诊所医学系进行了一项随机对照试验，共有 125 名在职医师参与，时间为 2013 年 10 月至 2014 年 10 月，并随后评估了组织计划的实施情况。12 个两周一次的自我主持讨论小组涉及反思、分享经验和小组学习，持续 6 个月。主要观察指标包括工作意义、倦怠、抑郁症状、生活质量、社会支持和工作满意度，使用经过验证的指标进行评估。
在干预结束后 6 个月（从基线开始 12 个月），干预组的整体倦怠率下降了 12.7%（31/62 至 19/51），而对照组则上升了 1.9%（25/61 至 24/56）（P<.001）。抑郁症状的发生率在干预组下降了 12.8%（29/62 至 17/50），而对照组则上升了 1.1%（20/61 至 19/56）（P<.001）。在接下来的 2 年内至少有中度自我报告离开当前工作可能性的医生比例，干预组下降了 1.9%（17/62 至 13/51），而对照组则上升了 6.1%（14/61 至 16/55）（P<.001）。虽然数字上的差异通常有利于干预组，但在倦怠量表评分、意义或社会支持的平均变化方面没有观察到统计学上的显著差异。
自我主持的医师小组会议改善了倦怠、抑郁症状和工作满意度。这种干预代表了一种促进医师幸福感重要方面的低成本策略。
clinicaltrials.gov 标识符：NCT04466423。
