Dataset Information

Efficacy of Interventions to Reduce Resident Physician Burnout: A Systematic Review.

ABSTRACT:

Background

Studies report high burnout prevalence among resident physicians, with little consensus on methods to effectively reduce it.

Objective

This systematic literature review explores the efficacy of interventions in reducing resident burnout.

Methods

PubMed, Embase, and Web of Science were searched using these key words: burnout and resident, intern, or residency. We excluded review articles, editorials, letters, and non-English-language articles. We abstracted data on study characteristics, population, interventions, and outcomes. When appropriate, data were pooled using random effects meta-analysis to account for between-study heterogeneity. Study quality was assessed using Newcastle-Ottawa Scale (cohort studies) and Jadad scale (randomized control trials [RCTs]).

Results

Of 1294 retrieved articles, 19 (6 RCTs, 13 cohort studies) enrolling 2030 residents and examining 12 interventions met criteria, with 9 studying the 2003 and 2011 Accreditation Council for Graduate Medical Education (ACGME) duty hour restrictions. Work hour reductions were associated with score decrease (mean difference, -2.73; 95% confidence interval (CI) -4.12 to -1.34; P?P?P?=?.008); and no effect on mean personal accomplishment score (0.93; 95% CI -0.19-2.06; P?=?.10) or for residents with high levels of personal accomplishment (OR?=?1.01; 95% CI 0.67-1.54; P?=?.95). Among interventions, self-care workshops showed decreases in depersonalization scores, and a meditation intervention reduced emotional exhaustion.

Conclusions

The ACGME work hour limits were associated with improvement in emotional exhaustion and burnout.

SUBMITTER: Busireddy KR

PROVIDER: S-EPMC5476377 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Efficacy of Interventions to Reduce Resident Physician Burnout: A Systematic Review.

Busireddy Kiran R KR Miller Jonathan A JA Ellison Kathleen K Ren Vicky V Qayyum Rehan R Panda Mukta M

Journal of graduate medical education 20170601 3

<h4>Background</h4>Studies report high burnout prevalence among resident physicians, with little consensus on methods to effectively reduce it.<h4>Objective</h4>This systematic literature review explores the efficacy of interventions in reducing resident burnout.<h4>Methods</h4>PubMed, Embase, and Web of Science were searched using these key words: <i>burnout</i> and <i>resident</i>, <i>intern</i>, or <i>residency</i>. We excluded review articles, editorials, letters, and non-English-language ar ...[more]

PMID: 28638506

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Project description:BackgroundInterest in the well-being of physicians has increased because of their contributions to the healthcare system quality. There is growing recognition that physicians are exposed to workplace factors that increase the risk of work stress. Long-term exposure to high work stress can result in burnout. Reports from around the world suggest that about one-third to one-half of physicians experience burnout. Understanding the outcomes associated with burnout is critical to understanding its affects on the healthcare system. Productivity outcomes are among those that could have the most immediate effects on the healthcare system. This systematic literature review is one of the first to explore the evidence for the types of physician productivity outcomes associated with physician burnout. It answers the question, "How does burnout affect physician productivity?"MethodsA systematic search was performed of: Medline Current, Medline in process, PsycInfo, Embase and Web of Science. The search period covered 2002 to 2012. The searches identified articles about practicing physicians working in civilian settings. Articles that primarily looked only at residents or medical students were excluded. Productivity was captured by hours worked, patients seen, sick leave, leaving the profession, retirement, workload and presenteeism. Studies also were excluded if: (1) the study sample was not comprised of at least 50% physicians, (2) the study did not examine the relationship between burnout and productivity or (3) a validated measure of burnout was not used.ResultsThe search identified 870 unique citations; 5 met the inclusion/exclusion criteria. This review indicates that globally there is recognition of the potential impact of physician burnout on productivity. Productivity was examined using: number of sick leave days, work ability, intent to either continue practicing or change jobs. The majority of the studies indicate there is a negative relationship between burnout and productivity. However, there is variation depending on the type of productivity outcome examined.ConclusionsThere is evidence that burnout is associated with decreased productivity. However, this line of inquiry is still developing. A number of gaps are yet to be filled including understanding how to quantify the changes in productivity related to burnout.

Project description:BACKGROUND: Physician empathy is both theoretically and empirically critical to patient health, but research indicates that empathy declines throughout medical school and is lower than ideal among physicians. In this paper, we synthesize the published literature regarding interventions that were quantitatively evaluated to detect changes in empathy among medical students, residents, fellows and physicians. METHODS: We systematically searched PubMed, EMBASE, Web of Science and PsychINFO in June of 2014 to identify articles that quantitatively assessed changes in empathy due to interventions among medical students, residents, fellows and physicians. RESULTS: Of the 1,415 articles identified, 64 met inclusion criteria. We qualitatively synthesized the findings of qualified studies by extracting data for ten study metrics: 1) source population, 2) sample size, 3) control group, 4) random assignment, 5) intervention type, 6) intervention duration, 7) assessment strategy, 8) type of outcome measure, 9) outcome assessment time frame, and 10) whether a statistically significant increase in empathy was reported. Overall, the 64 included studies were characterized by relatively poor research designs, insufficient reporting of intervention procedures, low incidence of patient-report empathy assessment measures, and inadequate evaluations of long-term efficacy. 8 of 10 studies with highly rigorous designs, however, found that targeted interventions did increase empathy. CONCLUSIONS: Physician empathy appears to be an important aspect of patient and physician well-being. Although the current empathy intervention literature is limited by a variety of methodological weaknesses, a sample of high-quality study designs provides initial support for the notion that physician empathy can be enhanced through interventions. Future research should strive to increase the sample of high-quality designs through more randomized, controlled studies with valid measures, explicit reporting of intervention strategies and procedures, and long-term efficacy assessments.

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Dataset Information

Efficacy of Interventions to Reduce Resident Physician Burnout: A Systematic Review.

Background

Objective

Methods

Results

Conclusions

Publications

Efficacy of Interventions to Reduce Resident Physician Burnout: A Systematic Review.

Similar Datasets

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