Better Together Physician Coaching ("Better Together", or "BT"), a 4-month, web-based positive psychology multimodal coaching program was built to decrease burnout in medical trainees. Here, the investigators seek to understand it's efficacy in University of Colorado School of Medicine (CU SOM) clinicians Aim 1: Implement Better Together in University of Colorado School of Medicine clinicians Aim 2: Assess outcomes: primary: reduce burnout as measured by the Maslach Burnout Index (goal: 10% relative improvement), and secondary: self-compassion, imposter syndrome, flourishing, loneliness, and moral injury. Aim 3: Advance the field of coaching for clinicians through innovation and dissemination of evidence-based approaches to clinician wellbeing.
Burnout refers to feelings of exhaustion, negativism, and reduced personal efficacy resulting from chronic workplace stress. In healthcare, burnout leads to increased medical errors, poorer patient care and negatively affects professional development and retention. Burnout is a growing problem that begins early in medical training. Professional coaching is a metacognition tool with a sustainable positive effect on physician well-being but typically relies on expensive consultants or time-consuming faculty development, often making it infeasible for medical training programs to offer. To overcome this barrier, the investigators created Better Together Physician Coaching (BT) a 4-month coaching program for at the University of Colorado (CU). BT includes regular online group-coaching, written coaching, and weekly self-study modules delivered by physician life coaches (Co-PIs). In 2021, the investigators studied BT in a group of female-identifying resident trainees at CU and found that the program significantly improved burnout, imposter syndrome, and self-compassion. This finding supports previous data that life coaching is effective for physicians and physicians in training. The investigators initially focused on women since burnout affects women to a greater degree than their male counterparts, and may have long-lasting consequences on their careers, contributing to a "leaky pipeline" effect. The pilot randomized controlled trial (RCT) of 101 BT women participants demonstrated a statistically significant improvement in burnout, self-compassion, and imposter syndrome in the intervention group. The investigators now seek to understand if the coaching program is also effective in clinicians of all gender identities. The hypothesis is that Better Together Physician Coaching ("Better Together", or "BT"), a 4-month, web-based positive psychology multimodal coaching program will result in decreased burnout in University of Colorado School of Medicine (CU SOM) clinicians. Aim 1: Implement Better Together in CU SOM clinicians Aim 2: Assess outcomes: primary: reduce burnout as measured by the Maslach Burnout Index (goal: 10% relative improvement), and secondary: self-compassion, imposter syndrome, flourishing, loneliness, and moral injury. Aim 3: Advance the field of coaching for clinicians through innovation and dissemination of evidence-based approaches to clinician wellbeing.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
160
thought-based coaching. This type of coaching focuses on thoughts and beliefs. It combines a cognitive behavioral therapy (CBT) model with mindfulness-based awareness and integrates theories of acceptance and commitment therapy (ACT), nonattachment, and radical questioning from Socratic and Greek philosophies. BT delivers a robust coaching experience via a 4-month web-based, group-coaching model. This novel program allows residents to participate as actively as they are inclined and able, offering flexibility via multiple modalities of coaching: twice weekly group coaching calls, unlimited anonymous written coaching, and weekly self-study modules that are housed on a secure members-only website.
No intervention - waitlist control
University of Colorado School of Medicine
Aurora, Colorado, United States
Burnout as defined by the Maslach Burnout Inventory (MBI): Change from pre to post test
The Maslach burnout inventory (MBI) is a 22-item measurement of worker burnout which assesses emotional exhaustion (EE), depersonalization (DP), and personal fulfillment (PF) domains. Possible scores range from 0-6 on a Likert scale for each item. Scores of EE ≥ 27 points, DP ≥ 10, and PF \<33 would indicate a high degree of burnout. Scores of EE≤18 points, DP≤5 points, and PF≥40 points would indicate a low degree of burnout.
Time frame: pretest will occur prior to the intervention and posttest will occur after the 4-month intervention.
Self-Compassion as defined by Neff's Self Compassion Score Short Form (SCS-SF): Change from pre to post test
Neff's Self Compassion Score Short Form (SCS-SF) is a 12-item measurement of self-compassion. Possible scores range from 0-6 on a Likert scale for each item, where the higher scale scores indicate greater self-compassion. Scores of 1.0- 2.49 are considered to be low, between 2.5-3.5 to be moderate, and 3.51-5.0 to be high.
Time frame: pretest will occur prior to the intervention and posttest will occur after the 4-month intervention
Moral Injury as defined by the Moral Injury Symptom Scale for Health Professions (MISS-HP): Change from pre to post test
Moral Injury Symptom Scale for Health Professions (MISS-HP) is a 10-item measurement of moral injury. Possible scores range from 0-5 on a Likert scale for each item, where the higher scale scores indicate greater moral injury. Scores \>35(on a possible score range of 10 to 100) are considered high for moral injury symptoms causing moderate to extreme problems with family, social, and occupational functioning.
Time frame: pretest will occur prior to the intervention and posttest will occur after the 4-month intervention
Imposter Syndrome as defined by Young's Imposter Syndrome Symptoms Scale (YISS): Change from pre to post test
Young's Imposter Syndrome Symptoms Scale (YISS) is a 8-item measurement of imposter syndrome. Scoring is yes/no where a score of \>5/8 is felt to be positive for imposter syndrome.
Time frame: pretest will occur prior to the intervention and posttest will occur after the 4-month intervention
Flourishing as defined by the Secure Flourish Index (SFI): Change from pre to post test
The Secure Flourish Index (SFI) is a 12 item measurement of flourishing at work and includes the domains of (D1) happiness and life satisfaction; (D2) physical and mental health; (D3) meaning and purpose; (D4) character and virtue; and (D5) close social relationships plus 2 questions on having adequate stability as well as material and financial resources so that flourishing is likely to continue. Scores range from a low of 0 to a high of 120, though the secure flourishing scores are often reported as averages of the questions (rather than sums) so that all scores are on a scale of 0-10.
Time frame: pretest will occur prior to the intervention and posttest will occur after the 4-month intervention
Loneliness as defined by the UCLA 3-item Loneliness Scale: Change from pre to post test
The UCLA 3-item Loneliness Scale measures feelings of loneliness. It is a shortened version of the 20-item Revised UCLA Loneliness Scale. Possible scores range from 1-3 on a Likert scale for each item with 1 = Hardly ever; 2 = Some of the time; 3 = Often. The three items are summed to give a total score between 3 to 9 with higher scores indicating a higher degree of loneliness.
Time frame: pretest will occur prior to the intervention and posttest will occur after the 4-month intervention
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