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

Overview

Journal J Grad Med Educ

Date 2017 Jun 23

PMID 28638506

Citations 117

Authors

Kiran R Busireddy

Jonathan A Miller

Kathleen Ellison

Vicky Ren

Rehan Qayyum

Mukta Panda

Affiliations

Soon will be listed here.

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: 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]).

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; < .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.

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

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