Abstract: Skills-based Training Programs Used to Reduce Physician-related Burnout in Graduate Medical Education: A Systematic Review

◆ Taylor Vasquez, University of Florida
◆ Carma Bylund, University of Florida

The effect of burnout on healthcare providers is well-documented yet lacks a solid foundation of evidence-based knowledge to properly affect change. According to the American Medical Association, 43.9% of United States physicians suffer burnout to some degree, with approximately 15% of physicians surveyed reporting clinical symptoms of depression. Past research has shown that the level of burnout a medical resident experiences correlates to how these physicians communicate with their patients and ultimately affects patient outcomes. Furthermore, when physicians use depersonalization to cope with intense emotional exhaustion, they communicate using more medical jargon and use a less personal style. Doctors in residency or fellowship training programs may be particularly susceptible to burnout. This study draws its theoretical frameworks from the communication theory of resilience which explains how communication processes help people construct their realities and have the capacity to enhance people’s abilities to bounce back from highly stressful triggers in daily life.

We are conducting a systematic review to examine the effectiveness of educational programs to reduce burnout in graduate medical education (e.g., residents and fellows).

This study is a work in progress. We are following the PRISMA guidelines in order to ensure our review procedures are rigorous, and we submitted our review protocol to PROSPERO. We have worked with two trained librarians to develop and refine the search strategy. Five databases (PubMed, PsychInfo, ERIC, Communication & Mass Media Complete, and Academic Search Premier) were searched with an open beginning date through November 2019. Eligible, included studies will be those that measure skills-based programs with the explicit, primary goal to reduce burnout within graduate medical education. Studies can be any type of experimental study design. Studies will be excluded if they do not report a skills-based intervention, do not have physician burnout as an outcome, or include participant samples outside of graduate medical education training programs. Using Covidence software, we plan to screen articles for inclusion in a two-phase process: (1) title and abstract; (2) full-text. Both phases will include two independent coders, with discrepancies reconciled through discussion.

The systematic review is currently in the screening stage and will be completed by March 2020. We will have the finished analysis to present in April 2020. We plan to present results and summary measures of the following: sample characteristics, type of study/sampling technique; how the trainings used were operationalized/measured; how the results of the study were recorded; how graduate medical trainees’ stress management was recorded; how burnout was measured and recorded; the level of change pre- and post-intervention (if applicable); and the main findings of the study. This study also relies on the Kirkpatrick Assessment model, which is one of the most commonly used methods for program and training evaluation. Only outcomes focused in either Level 3 (evaluating behavior) or Level 4 (evaluating results) of the Kirkpatrick Assessment Model will be included.