Burnout Preventions, Professionalism Heightening, and Enhancing Resiliency (BUPHER) (BUPHER)

Values and Virtues in Medical Practice: Quasi-Experimental Intervention for Burnout Preventions, Professionalism Heightening, and Enhancing Resiliency (BUPHER) in a Hospital Surgical Division

Due to their difficult and stressful work surgeons are under continuous physical and mental stress exposing them to increased risk for burnout and lack of professionalism. The present intervention focuses on providing time and a safe space to debrief and explore personal and group experiences and dilemmas, as well as acquire coping skills related to burnout, communication and professionalism.

Study Overview

• Status: Unknown
• Conditions: Burnout, Professional; Professional-Patient Relations
• Intervention / Treatment: Other: Preventing Professionals burnout

• Study Type: Interventional
• Enrollment (Anticipated): 1000
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Orit Karnieli-Miller, PhD; Phone Number: +972502060619; Email: oritkm@gmail.com
• Study Contact Backup: Name: Nathaniel Laor, MD; PhD; Phone Number: +972546441354; Email: nlaor@me.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• All physicians (residents and experts) of the Surgical Division at Tel Aviv Sourasky Medical Center.
• All medical students studying at the Sackler Faculty of Medicine, Tel Aviv University, and attending a surgery round at the Surgical Division at Tel Aviv Sourasky Medical Center.
• Patients (and/or family members) in the Surgical Division at Tel Aviv Sourasky Medical Center following their surgery.

Exclusion Criteria:

• The research will not include children and/or judgment-impaired patients;
• population not met by inclusion criteria;
• non-Hebrew speaking patients;
• ventilated patients;
• patients in surgical intensive care;
• patients medically defined as suffering from clouding of conscious or delirium;
• subjects who decided to stop their participation in the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Structured group intervention; Experimental: Structured group intervention a 'structured' intervention, leaning mostly on tools designed to prevent burnout and promote resilience, including predetermined exercises and topics as discussion goals in each meeting. Fidelity will be checked and monitored at the end of each meeting, when facilitators fill out a form that summarizes the content, topics and coping skills acquired in each session.	Other: Preventing Professionals burnout; Other Names: Enhancing professional professional conduct
Experimental: Semi-Structured group intervention; Experimental: Semi-Structured group intervention a 'semi-structured' intervention, based on tools for developing an emotional discourse, building a supporting team and self reflection. The 'semi-structured' intervention offers predetermined contents that are discussed through the stories and needs presented by group members. Fidelity will be checked and monitored at the end of each meeting, when facilitators fill out a form that summarizes the content, topics and coping skills acquired in each session.	Other: Preventing Professionals burnout; Other Names: Enhancing professional professional conduct

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Professionalism Culture Scale	12 item scale developed by the American Board of Internal Medicine, by (DeLisa, Foye, Jain, Kirshblum, & Christodoulou, 2001	Change (increase) from baseline to short and long term measurements (after one year, 3 years, respectively)
Abbreviated Burnout Scale	Nine item scale focused on 3 burnout factors (Iverson, Olekalns & Erwin, 1998)	Change (decrease) from baseline to short and long term measurements (after one year, 3 years, respectively)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Adapted Professionalism Mini-Evaluation Scale Exercise scale	originally included 24 items developed by Cruess, McIlroy, Cruess, Ginsburg, and Steinert (2006). Translated and adapted by the research team, and now include 31 items.	Change (increase) from baseline to short and long term measurements (after one year, 3 years, respectively)
Cynicism in Medicine Questionnaire (CMQ)	14 item questionnaire developed by Teserman, Morton, Loo, Worthle & Lamberton, 1996	Change (decrease) from baseline to short and long term measurements (after one year, 3 years, respectively)
Moral & Cognitive Courage Scale	A newly developed questionnaire focused on self efficacy to intervene when a physician acts immorally and actual experience with acting in such cases.	Change (increase) from baseline to short and long term measurements (after one year, 3 years, respectively)
Jefferson Health Professionals Empathy Scale	20 items questionnaire developed by Hojat, Mangione, Nasca, Cohen, Gonnella, Erdmann & Magee, 2001	Change (increase) from baseline to short and long term measurements (after one year, 3 years, respectively)
The Areas of Work life Scale (AWS)	29 items questionnaire developed by Leiter & Maslach, 2004 to measure 6 factors related to work load, control, appreciation, community, fairness and values	Change (increase in balance) from baseline to short and long term measurements (after one year, 3 years, respectively)
Professionals Self Care Practices questionnaire	43 items comprised from two questionnaires focused on different aspects of self care (Teng, Yen & Fetzer & Shananfelt et al., 2005). the combination of these two questionnaires was assessed by Karnieli-Miller & Michael.	Change (increase) from baseline to short and long term measurements (after one year, 3 years, respectively)
Life satisfaction questionnaire	3 item questionnaire focused on general life satisfaction.	Change (increase) from baseline to short and long term measurements (after one year, 3 years, respectively)
Perceived Stress Scale (PSS)	10 item scale focused on perceived stress in the clinics (4 items validated in Ben-Zur & Michael) and 6 items developed by the research team to assess concern and fear from medical mistakes and hierarchy.	Change (decrease) from baseline to short and long term measurements (after one year, 3 years, respectively)
Work-Life Balance	6 item questionnaire developed by Greenhaus & Powell, 2006)	Change (increase) from baseline to short and long term measurements (after one year, 3 years, respectively)
Resilient Coping Questionnaire (RCQ)	24 items questionnaire developed by Wolmer, Hamiel & Laor (2105)	Change (increase) from baseline to short and long term measurements (after one year, 3 years, respectively)
Specific Life Satisfaction Questionnaire	12 items questionnaire developed by Karnieli-Miller & Michael to measure satisfaction with different life domains (e.g., relationships, financial etc).	Change (increase) from baseline to short and long term measurements (after one year, 3 years, respectively)
Brief Resilience Scale (BRS)	6 item questionnaire developed by Smith et al., 2008	Change (increase) from baseline to short and long term measurements (after one year, 3 years, respectively)
Patient Satisfaction questionnaire	23 items questionnaire focused on patient-physician communication skills and satisfaction from care.	Change (increase) from baseline to short and long term measurements (after one year, 3 years, respectively)
Physician Transcendence Scale (PTS)	A 16 items newly developed questionnaire focused on the physicians' transcendence. Laor, Wolmer & Hamiel	Baseline
Demographic information questions	questions concerning gender, age, seniority, specialty, country of birth,	Baseline
Life Events Scale	Assessing life events the individual experienced, such as divorce, a death of a loved one, etc.	Baseline

Collaborators and Investigators

• Sponsor: michal roll
• Collaborators: Tel Aviv University; Association for Children at Risk

Study record dates

Study Major Dates

• Study Start: November 1, 2016
• Primary Completion (Anticipated): September 1, 2019
• Study Completion (Anticipated): September 1, 2020

Study Registration Dates

• First Submitted: September 4, 2016
• First Submitted That Met QC Criteria: November 14, 2016
• First Posted (Estimate): November 15, 2016

Study Record Updates

• Last Update Posted (Estimate): November 15, 2016
• Last Update Submitted That Met QC Criteria: November 14, 2016
• Last Verified: November 1, 2016

More Information

Terms related to this study

• Keywords: Resiliency; Professionalism; Burnout prevention; Student education
• Additional Relevant MeSH Terms: Behavioral Symptoms; Stress, Psychological; Occupational Stress; Occupational Diseases; Burnout, Professional; Burnout, Psychological
• Other Study ID Numbers: TASMC-16-GL-0426-CTIL

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The participants data will be shared with the research team from the Department of Medical Education, Sackler Faculty of Medicine, Tel Aviv University and Cohen-Harris Resilience Center