Efficacy of Interventions to Reduce Resident Physician Burnout: A Systematic Review
Studies report high burnout prevalence among resident physicians, with little consensus on methods to effectively reduce it. This systematic literature review explores the efficacy of interventions in reducing resident burnout. PubMed, Embase, and Web of Science were searched using these key words:...
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| Published in | Journal of graduate medical education Vol. 9; no. 3; pp. 294 - 301 |
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| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
The Accreditation Council for Graduate Medical Education
01.06.2017
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| Subjects | |
| Online Access | Get full text |
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| Summary: | Studies report high burnout prevalence among resident physicians, with little consensus on methods to effectively reduce it.
This systematic literature review explores the efficacy of interventions in reducing resident burnout.
PubMed, Embase, and Web of Science were searched using these key words:
and
,
, or
. 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]).
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;
< .001) and lower odds ratio (OR) for residents reporting emotional exhaustion (42%; OR = 0.58; 95% CI 0.43-0.77;
< .001); a small, significant decrease in depersonalization score (-1.73; 95% CI -3.00 to -0.46;
= .008); and no effect on mean personal accomplishment score (0.93; 95% CI -0.19-2.06;
= .10) or for residents with high levels of personal accomplishment (OR = 1.01; 95% CI 0.67-1.54;
= .95). Among interventions, self-care workshops showed decreases in depersonalization scores, and a meditation intervention reduced emotional exhaustion.
The ACGME work hour limits were associated with improvement in emotional exhaustion and burnout. |
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| Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 ObjectType-Review-4 content type line 23 ObjectType-Undefined-3 Kiran R. Busireddy, MD, is Transitional Year Resident, Department of Transitional Year, University of Tennessee College of Medicine–Chattanooga; Jonathan A. Miller, MD, is Transitional Year Resident, Department of Transitional Year, University of Tennessee College of Medicine–Chattanooga; Kathleen Ellison, MD, is Transitional Year Resident, Department of Transitional Year, University of Tennessee College of Medicine–Chattanooga; Vicky Ren, MD, is Transitional Year Resident, Department of Transitional Year, University of Tennessee College of Medicine–Chattanooga; Rehan Qayyum, MD, MHS, FAHA, is Professor and Chair, Division of Hospital Medicine, Virginia Commonwealth University School of Medicine; and Mukta Panda, MD, FACP, is Professor, Department of Medicine, Assistant Dean, Medical Student Education, and Program Director, Transitional Year Program, Department of Transitional Year, University of Tennessee College of Medicine–Chattanooga. Editor's Note: The online version of this article contains the Newcastle-Ottawa Scale for scoring nonrandomized cohort studies and figures of emotional exhaustion, depersonalization, and personal accomplishment with both preintervention and postintervention mean differences between duty hour restrictions. Funding: The authors report no external funding source for this study. These data were presented as an oral presentation at the Society of General Internal Medicine (SGIM), Southern Regional Meeting, Atlanta, Georgia, February 19, 2016, and the Annual Meeting of the SGIM, Hollywood, Florida, May 11–14, 2016. Conflict of interest: Dr Qayyum is a consultant for Sunovion Pharmaceuticals Inc. |
| ISSN: | 1949-8349 1949-8357 |
| DOI: | 10.4300/jgme-d-16-00372.1 |