Khalili Joshua, Miotto Karen, Wang Tisha, Mafi John N, Kyababchyan Elizabeth, Sanford Jesse, Elashoff David, Brook Jenny, Adebambo Yetunde, Smith Paige-Ashley I, Nguyen Emma, Yoo Sun M
Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, USA.
Department of Psychiatry, David Geffen School of Medicine at University of California, Los Angeles, CA, USA.
J Gen Intern Med. 2025 Jul 11. doi: 10.1007/s11606-025-09653-w.
Physician burnout is a public health crisis. While one-on-one professional coaching reduces physician burnout, its costs may limit widespread use. Small group professional coaching could offer a more scalable solution, but its effects on attending physician burnout remain unknown.
To determine the effects of small group and one-on-one professional coaching to decrease physician burnout and improve work life, work engagement, self-efficacy, and social support.
A randomized, three-arm, waitlist-controlled trial from March 2, 2023 to April 13, 2024.
79 Internal Medicine faculty attending physicians.
Six, one-hour, virtual one-on-one or small group professional coaching sessions rooted in positive psychological theory within 4 months.
The primary outcome was overall burnout, measured by the Maslach Burnout Inventory (MBI). Secondary outcomes included MBI subscale measures, Areas of Worklife (workload, control, rewards, community, fairness, and values), work engagement (vigor, dedication, absorption), self-efficacy and social support, evaluated by validated measures. Outcomes were also evaluated 6 months post-intervention.
Small group and one-on-one coaching intervention participants experienced a 29.6% and 13.4% absolute reduction in the rate of burnout respectively, compared with an 11.1% increase among control physicians (difference-in-differences, -40.7% [95% CI, -71.3%, -10.1%], P = 0.01 and -25.0% [95% CI, -53%, 3%], P = 0.09, respectively). There was no significant difference in burnout reduction between small group vs one-on-one interventions (-15.9% [95% CI, -41.7%, 9.9%], P = 0.22). After 6 months, burnout remained stable in the small group intervention and continued to decrease in the one-on-one group, both without further intervention.
In this randomized clinical trial, small group professional coaching decreased physician burnout though no statistically significant effect was detected in the one-on-one coaching arm. Small group coaching may offer a less costly and nationally scalable approach to address the physician burnout crisis. Replication of these methods are warranted in a larger, multi-centered randomized trial.
ClinicalTrials.gov NCT05583435.
医生职业倦怠是一场公共卫生危机。虽然一对一的专业辅导可减轻医生职业倦怠，但其成本可能限制其广泛应用。小组专业辅导可能提供一种更具可扩展性的解决方案，但其对主治医生职业倦怠的影响尚不清楚。
确定小组和一对一专业辅导对减轻医生职业倦怠、改善工作生活、工作投入、自我效能感和社会支持的效果。
一项从2023年3月2日至2024年4月13日的随机、三臂、等待名单对照试验。
79名内科教职主治医生。
在4个月内进行六次、每次一小时、基于积极心理学理论的虚拟一对一或小组专业辅导课程。
主要结局是通过马氏职业倦怠量表（MBI）测量的总体职业倦怠。次要结局包括MBI分量表测量、工作生活领域（工作量、控制权、奖励、群体、公平性和价值观）、工作投入（活力、奉献、专注度）、自我效能感和社会支持，通过经过验证的测量方法进行评估。干预后6个月也对结局进行了评估。
与对照组医生职业倦怠率增加11.1%相比，小组和一对一辅导干预参与者的职业倦怠率分别绝对降低了29.6%和13.4%（差异差值分别为-40.7%[95%CI，-71.3%，-10.1%]，P = 0.01和-25.0%[95%CI，-53%，3%]，P = 0.09）。小组干预与一对一干预在职业倦怠降低方面无显著差异（-15.9%[95%CI，-41.7%，9.9%]，P = 0.22）。6个月后，小组干预中职业倦怠保持稳定，一对一小组中职业倦怠继续下降，两者均未进行进一步干预。
在这项随机临床试验中，小组专业辅导降低了医生职业倦怠，尽管在一对一辅导组中未检测到统计学上的显著效果。小组辅导可能提供一种成本较低且可在全国范围内扩展的方法来应对医生职业倦怠危机。这些方法有必要在更大规模的多中心随机试验中进行重复验证。
ClinicalTrials.gov NCT05583435
