Evaluation of a novel intervention to reduce burnout in doctors-in-training using self-care and digital wellbeing strategies: a mixed-methods pilot

Abstract

Background Burnout for doctors-in-training is increasingly cause for concern. Our objectives were to assess the feasibility, acceptability and impact of a novel intervention to reduce burnout and improve wellbeing. This is the first wellbeing intervention for medical doctors to include strategies for work-life boundary management and digital wellbeing. Methods Twenty-two doctors participated in face-to-face workshops which included group discussion of challenges experienced and strategies to enhance self-care and wellbeing. A pre-post-test mixed-methods evaluation was undertaken. Questionnaire measures were the Oldenburg Burnout Inventory, Warwick-Edinburgh Mental Wellbeing Scale and the boundary control subscale of the Work-Life Indicator (i.e., the degree of perception of control of the boundaries between work and personal life). Paired t-tests examined whether there were statistically significant differences. Eleven doctors also participated in post-intervention semi-structured interviews. Transcripts were analysed using thematic analysis. Results The intervention was well-received, with all trainees finding the workshop useful and saying they would recommend it to others. At baseline most participants had scores indicative of burnout on both the disengagement (82%) and exhaustion (82%) subscales of the Oldenburg Burnout Inventory. One month post-intervention, participants had a statistically significant reduction in burnout (both disengagement and exhaustion) and improvement in boundary control. Wellbeing scores also improved, but differences were not statistically significant. Qualitative analysis indicated participants had welcomed a safe space to discuss stressors and many had implemented digital wellbeing strategies to manage their smartphone technology, and increased self-care such as mindfulness practice and walking in green space. Conclusions The intervention reduced burnout and improved boundary control. We suggest that having protected time for doctors to share personal experiences, adopt digital wellbeing and self-care strategies are effective tools to support doctors’ wellbeing and should be investigated further.

Feasibility, acceptability and effect of the Mindful Practice curriculum in postgraduate training of general practitioners

“…However, MBIs, similar to MPC, that included multiple essential mindfulness elements (development of greater attentional, emotional and behavioural self-regulation, as well as positive qualities such as compassion, wisdom, equanimity) in their content, or that employed a group-based training format, mostly showed positive effects [23][24][25]. While ours is the first study to focus on GP trainees using MPC and addressing specific needs and dynamics of physician's activity, other MBIs have been shown to improve levels of mindfulness and reduce burnout in primary care professionals in Brazil [26], psychiatry trainees in Australia [27] and foundation trainee doctors and medical students in the UK [28,29]. The latter study was an adaptation of the Mindfulness Based Cognitive Therapy (MBCT) programme for the workplace.…”

“…While ours is the first study to focus on GP trainees using MPC and addressing specific needs and dynamics of physician’s activity, other MBIs have been shown to improve levels of mindfulness and reduce burnout in primary care professionals in Brazil [ 26 ], psychiatry trainees in Australia [ 27 ] and foundation trainee doctors and medical students in the UK [ 28 , 29 ]. The latter study was an adaptation of the Mindfulness Based Cognitive Therapy (MBCT) programme for the workplace.…”

What Works to Improve Wellbeing? A Rapid Systematic Review of 223 Interventions Evaluated with the Warwick-Edinburgh Mental Well-Being Scales

“…After initial title-abstract screening, 473 records underwent full-text review. Although 228 records met criteria, some reported duplicate data for the same sample and intervention, further reducing to 209 studies included in the review [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , …”

“…Mapping of the interventions revealed four main intervention themes: (1) psychological (n = 80) [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 ,…”

“…Five sub-themes emerged under the psychological theme: (1) 18 interventions on resilience, self-management and wellness [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ]; (2) 16 mindfulness intervention studies [ 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ]; (3) 9 psychoeducation intervention studies [ 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 ]; (4) 18 cognitive behavioural therapy (CBT) studies [ 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 ,…”