Hata Susan R, Berkowitz Lori R, James Kaitlyn, Simpkin Arabella L
Dr. Hata: Assistant Professor, Department of Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, Department of Medicine, Massachusetts General Hospital, Boston, MA, and Harvard Medical School, Boston, MA. Dr. Berkowitz: Harvard Medical School, Boston, MA and Vice Chair of Education and Wellness, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA. Dr. James: Epidemiologist, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA. Dr. Simpkin: Assistant Professor, Department of Medicine, Massachusetts General Hospital, Boston, MA, Harvard Medical School, Boston, MA, and Department of Pharmacology, University of Oxford, Oxford, United Kingdom.
J Contin Educ Health Prof. 2022 Jan 1;42(1):e75-e82. doi: 10.1097/CEH.0000000000000404.
To evaluate the effect on engagement, relational connection, and burnout of an intervention involving clinical faculty meeting in interprofessional self-facilitated groups and to determine whether a written discussion guide is necessary to achieve benefit.
This is a randomized controlled trial, conducted at a large US academic medical center from May to August 2018. Subjects included 25 clinical physicians, nurse practitioners, and certified nurse midwives. The intervention involved three monthly self-facilitated groups for faculty. Groups were randomized to have no discussion guide, or to receive a one-page guide. Outcomes of burnout, engagement, and empowerment in work, and stress from uncertainty were assessed using validated metrics.
Rates of emotional exhaustion and depersonalization decreased significantly over the course of the 3-month study (56%-36%; P < .001; and 20%-15%; P = .006) and overall burnout decreased from 56% to 41% of faculty (P = .002). The percentage of faculty who felt engaged in their work increased from 80% to 96% (P = .03). No statistically significant differences in empowerment at work or in reaction to uncertainty were seen. The groups without a discussion guide had equivalent outcomes and benefits. Cost per participant was under $100.
A three-month, low-cost, self-facilitated series of dinner meetings for interprofessional clinical faculty decreased burnout and improved engagement, sense of connection to colleagues, and sense of departmental commitment to well-being. Structured discussion guides were not necessary to achieve benefit. This study broadens the possibilities for cost-effective opportunities to transform institutional culture and effectively enhance faculty well-being.
评估跨专业自我引导小组中临床教员会议干预措施对参与度、关系连接和职业倦怠的影响，并确定书面讨论指南对实现效益是否必要。
这是一项随机对照试验，于2018年5月至8月在美国一家大型学术医疗中心进行。受试者包括25名临床医生、执业护士和认证助产士。干预措施包括为教员举办三次每月一次的自我引导小组会议。各小组被随机分为不使用讨论指南或接受一页式指南。使用经过验证的指标评估职业倦怠、工作参与度、赋权以及不确定性带来的压力等结果。
在为期3个月的研究过程中，情感耗竭和去个性化发生率显著下降（分别从56%降至36%；P <.001；以及从20%降至15%；P =.006），总体职业倦怠率从教员的56%降至41%（P =.002）。感到工作投入的教员比例从80%增至96%（P =.03）。在工作赋权或对不确定性的反应方面未发现统计学上的显著差异。未使用讨论指南的小组取得了同等的结果和效益。每位参与者的成本低于100美元。
为跨专业临床教员举办的为期三个月、低成本、自我引导的系列晚餐会议降低了职业倦怠，提高了参与度、与同事的联系感以及部门对幸福感的承诺感。实现效益无需结构化讨论指南。本研究拓宽了通过具有成本效益的机会来转变机构文化并有效提升教员幸福感的可能性。
