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. 2023 May 12;2023(5):CD002892. doi: 10.1002/14651858.CD002892.pub6

Dyrbye 2019.

Study characteristics
Methods Study design: randomised controlled trial
Study grouping: parallel group
Participants Baseline characteristics
Coaching

  • Age (31‐40, 41‐50, 51‐60, > 60): 7/44 (15.9), 25/44 (56.8), 12/44 (27.3), 0/44  (0)

  • Sex (N (% female)): 20 (46%)

  • Sample size: 44

  • Years of experience (mean ± SD): 15.8 (7.2)


Control (wait list)

  • Age (31‐40, 41‐50, 51‐60, > 60): 7/42 (16.7), 20/42 (47.6), 12/42 (28.6), 3/42 (7.1)

  • Sex (N (% female)): 28 (64%)

  • Sample size: 44

  • Years of experience (mean ± SD): 15.7 (8.3)


Overall

  • Age (31‐40, 41‐50, 51‐60, > 60): NR

  • Sex (N (% female)): NR

  • Sample size: NR

  • Years of experience (mean ± SD): NR


Included criteria: Individuals who had been in practice for 5 to 30 years were eligible
Excluded criteria: NR
Pretreatment: no group differences reported
Type of healthcare worker: exclusively physician
Response rate: 12%
Compliance rate: Participants randomised to the intervention group had a mean of 5.5 coaching sessions (range, 0‐6 coaching sessions).
Interventions Intervention characteristics
Coaching

  • Type of the intervention: Intervention type 1 ‐ to focus one’s attention on the experience of stress

  • Description of the intervention: All coaching sessions were performed by telephone. The initial coaching session focused on creating the relationship, assessing needs, identifying values, setting goals, and creating an action plan. Subsequent sessions followed the same general structure: (1) check in, debrief strategic action the participant had taken since the last session, manage progress, and re‐view accountability; (2) plan and set goals; (3) design actions to incorporate into daily life; (4) commit to next steps; and (5) checkout and summarise. The topics individuals could request coaching on were unscripted and individualised. Coaches made brief notes of the topics discussed. Participants randomised to the intervention group were expected to see the same number of patients as their colleagues who were not in the intervention group. Participants who scheduled their coaching during their clinical time were expected to make up the patient visits by seeing additional patients at other times (e.g. adding extra patients before or after their standard clinical time on other days). Example: optimising meaning in work; aligning values and priorities with work‐related tasks; ensuring work activities align with the aspects of work perceived as most meaningful; reconsidering nonclinical roles, integrating personal and professional life; sharing tasks with partner; meeting needs of ageing parents; reducing work‐home conflicts; building social support and community at work; strategies to network with colleagues; taking breaks at work with colleagues; building peer relationships; addressing stressful relationships with colleagues; improving work efficiency; steps to increase efficiency with email and other tasks; delegating tasks, setting boundaries with patients, collaborating with colleagues, and obtaining additional EHR training; addressing workload; prioritising and saying “no”; avoiding ove‐scheduling; setting expectations; setting goals; establishing roles and responsibilities; building leadership skills; building teams; changing management; influencing leaders; challenging conversations; pursuing hobbies and recreation; finding time and discovering interests; engaging in self‐care; strategising to get exercise; eating healthy, attending to medical needs; strengthening relationships outside of work; proactively scheduling social events with friends; spending more time with family; showing appreciation towards others; being grateful.

  • The number of sessions: 6

  • Duration of each session on average: 30 minutes

  • Duration of the entire intervention: 5 months

  • Duration of the entire intervention short vs long: Long

  • Intervention deliverer: Credentialed professional coaches

  • Intervention form: Individual by telephone


Control (wait list)

  • Type of the intervention: Wait list

  • Description of the intervention: Participants randomised to the control group received no intervention during the 5 months of the study but were provided with access to Bluepoint coaches for an equivalent number of coaching contact hours (3.5 hours) during the 5 months after the conclusion of the active study interval.

  • The number of sessions: NA

  • Duration of each session on average: NA

  • Duration of the entire intervention: NA

  • Duration of the entire intervention short vs long: NA

  • Intervention deliverer: NA

  • Intervention form: NA
Outcomes Maslach Burnout Inventory ‐ Emotional exhaustion

  • Outcome type: ContinuousOutcome


Maslach Burnout Inventory ‐ Depersonalization

  • Outcome type: ContinuousOutcome


Maslach Burnout Inventory ‐ Personal accomplishment

  • Outcome type: ContinuousOutcome
Identification Sponsorship source: Funding for this study was provided by the Mayo Clinic Department ofMedicine Program on Physician Well‐Being and thePhysician Foundation
Country: USA
Setting: Mixed healthcare settings including the department of medicine, family medicine and pediatric
Comments: NR
Authors name: Liselotte N.Dyrbye
Institution: Department of Medicine, Program on Physician Well‐Being, Mayo Clinic
Email: dyrbye.liselotte@mayo.edu
Address: 200 First StSW, Rochester, MN 55905
Time period: 2017‐2018
Notes We kindly received the mean and SD of the MBI‐EE for both groups from author C. West.  
MBI‐EE included in analysis 1.1
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Quote: "We used a computer‐generated dynamic allocation algorithm to randomize participants into a coaching group and a control group. Randomization"
Allocation concealment (selection bias) Unclear risk Quote: "We used a computer‐generated dynamic allocation algorithm to randomize participants into a coaching group and a control group. Randomization was stratified by years in practice, work site (Arizona, Florida, Minnesota, or Mayo Clinic Health System), and primary care (family medicine, general pediatrics, or general internal medicine) vs sub‐specialty practice."
Insufficient information to understand whether intervention allocations could have been foreseen in advance of, during, enrolment.
Blinding of participants and personnel (performance bias)
All outcomes High risk Participants were not blinded
Blinding of outcome assessment (detection bias)
All outcomes High risk Participants were not blinded whereas outcomes are self‐reported.
Incomplete outcome data (attrition bias)
All outcomes Low risk 82 of the 88 completed follow‐up >93%
Selective reporting (reporting bias) Low risk The authors report a trial register. For the outcomes that we are interested in, there is no selective outcome reporting.
Other bias Unclear risk Low participation rate (88 of the 764 eligible physicians participated)