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Effect of a professional coaching intervention on the well-being and distress of physicians: A pilot randomized clinical trial (Dyrbye et al., 2019)

Absence of conflict of interest.

Citation

Dyrbye, L. N., Shanafelt, T. D., Gill, P. R., Satele, D. V., & West, C. P. (2019). Effect of a professional coaching intervention on the well-being and distress of physicians: A pilot randomized clinical trial. JAMA Internal Medicine, 179(10), 1406–1414.

Highlights

  • The study’s objective was to examine the impact of professional coaching on physicians’ well-being outcomes. 

  • The study is a randomized controlled trial. Participants completed surveys at the beginning and end of the five-month study period. The authors compared the outcomes of treatment and comparison group members. 

  • The study found that participants who received professional coaching had a significant reduction in overall symptoms of burnout.  

  • The quality of the causal evidence is high for health and safety outcomes related to burnout. This means we are confident that the estimated effects are attributable to professional coaching and not to other factors. The quality of causal evidence is low for health and safety outcomes related to quality of life and resilience, for attitudes outcomes related to job satisfaction, and for engagement and meaning at work because the authors did not include information on sample attrition nor did they account for preexisting differences between treatment and control groups. This means we are not confident that the estimated effects are attributable to professional coaching; other factors are likely to have contributed. 

Intervention Examined

Professional Coaching for Physicians

Features of the Intervention

This study examined a professional coaching intervention for physicians. The intervention comprised a 1-hour initial coaching session followed by five 30 minute sessions, totaling 3.5 hours, completed over five months. Credentialed professionals provided coaching sessions focused on well-being and distress via telephone to physicians who worked in the departments of medicine, family medicine, and pediatrics at Mayo Clinic in Rochester, Minnesota; Jacksonville, Florida; and Scottsdale, Arizona; or Mayo Clinic Health System campuses in Wisconsin and Minnesota.  

Features of the Study

The study is a randomized controlled trial that was conducted from October 2017 to March 2018. Physicians who had been in practice for 5 to 30 years were eligible to participate. Participants were recruited via email and departmental announcements and randomly assigned to treatment and control groups. A total of 764 physicians were eligible for the intervention. Of those, 88 volunteered for the study and were evenly assigned to the treatment and control groups. Random assignment was stratified by years in practice, work site, and primary care. The study participants had an average of about 16 years in practice; most spent more than 50 percent of their time in direct patient care; and most were ages 41 to 50. The sample included 48 female participants and 40 male participants. 

Physicians in the treatment group received an average of 5.5 professional coaching sessions on well-being and distress. Participants completed surveys at the beginning and end of the five-month study period. The surveys were administered electronically by the Mayo Clinic Survey Research Center.   

Eighty-two of these 88 physicians were included in the final analysis for outcomes examined using the Maslach Burnout Inventory scale. The authors did not report the final analytic sample size for outcomes examined using other measures. The authors compared the outcomes of physicians who received the professional coaching to physicians who received no intervention during the five months of the study.  

Findings

Health and safety: 

  • Rates of overall burnout at five months decreased by 17.1 percentage points in the treatment group but increased by 4.9 percentage points in the control group. The finding was statistically significant. 

  • The study also found a statistically significant relationship between the professional coaching intervention and other outcomes using the Maslach Burnout Inventory subscales, including reduced emotional exhaustion scores and rates of high emotional exhaustion, but did not find a significant relationship between the professional coaching and reduced depersonalization scores and the rates of high depersonalization, nor increased personal accomplishment scores.  

  • The study found a statistically significant relationship between the professional coaching intervention and improved quality of life and resilience scores.  

Attitudes:  

  • The study did not find a statistically significant relationship between the professional coaching intervention and increase in job satisfaction, nor engagement and meaning at work scores. 

Considerations for Interpreting the Findings

Although the study was a well-implemented randomized controlled trial for health and safety outcomes related to burnout, the authors did not provide the analytic sample sizes for outcomes related to quality of life, resilience, job satisfaction, engagement, and meaning at work outcomes. Therefore, it was not possible to calculate attrition for these impact estimates in the study. 

Causal Evidence Rating

The quality of the causal evidence is high for health and safety outcomes related to burnout because it was based on a well-implemented randomized controlled trial. This means we are confident that the estimated effects are attributable to professional coaching and not to other factors.  

The quality of causal evidence is low for health and safety outcomes related to quality of life and resilience, for attitudes outcomes related to job satisfaction, and for engagement and meaning at work. The authors did not include sample attrition nor did they account for preexisting differences between treatment and control groups. This means we are not confident that the estimated effects are attributable to professional coaching; other factors are likely to have contributed. 

Reviewed by CLEAR

May 2021