The Effect of Community Building Through Virtual, Team-Based Exercise on Burnout (MedMotion)

The MedMotion Trial on Community Building Through Virtual, Team-Based Exercise and Affects on Physician and Trainee Burnout: A Randomized, Controlled, Multi-Center Trial

This study is a randomized controlled trial that will look at whether virtual, team-based exercise improves burnout, sense of community, and mentorship connections among medical students, residents, fellows, and physicians.

Study Overview

• Status: Active, not recruiting
• Conditions: Burnout, Professional; Burnout, Student; Exercise; Community Building; Mentorship
• Intervention / Treatment: Behavioral: First 3 months of virtual, team-based exercise; Behavioral: Second 3 months of virtual, team-based exercise

Detailed Description

Participants will be randomized to either a control group or an intervention group. The intervention group will be further randomized onto teams that will exercise for 3 months. All exercise (including walking, biking, lifting, yoga, and 40+ exercises) will be tracked via user's smartwatches (ie Apple, Garmin), smartphone fitness apps (ie MapMyRun), or manual upload, converted into Metabolic Equivalent of a Task (MET) minutes, and displayed on online leaderboards. Group activities will be encouraged by awarding raffle tickets for prizes to those who submit pictures with their teammates. Primary outcomes will be burnout, sense of community, and mentorship connections, with the hypothesis that getting everyone together for this team-based exercise will improve these metrics. After 3 months, both the control and intervention group will be enrolled in 3 months of the intervention to assess secondary outcomes: long-term burnout, sense of community, and mentorship connections, as well as adherence.

• Study Type: Interventional
• Enrollment (Actual): 422
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Massachusetts
    • Boston, Massachusetts, United States, 02115
      • Massachusetts General Hospital
    • Boston, Massachusetts, United States, 02114
      • Harvard Medical School

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Harvard Medical Students (HMS)
• Massachusetts General Hospital (MGH) Residents, Fellows, or Attendings

Exclusion Criteria:

• Non HMS Students or MGH Residents, Fellows, or Attendings

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention; 6 months of virtual, team-based exercise	Behavioral: First 3 months of virtual, team-based exercise; Participants will be randomized onto mixed teams of medical students, residents, fellows, and attendings and registered for the virtual, team-based exercise intervention on FitRankings.com. All exercise (including walking, biking, lifting, yoga, and 40+ exercises) will be tracked via user's smartwatches (ie Apple, Garmin), smartphone fitness apps (ie MapMyRun), or manual upload, converted into Metabolic Equivalent of a Task (MET) minutes, and displayed on online leaderboards. Group activities will be encouraged by awarding raffle tickets for prizes to those who submit pictures with their teammates.; Behavioral: Second 3 months of virtual, team-based exercise; Same as above
Other: Control; 3 months of usual exercise and then 3 months of virtual, team-based exercise	Behavioral: Second 3 months of virtual, team-based exercise; Same as above

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from Baseline Burnout at 3 months	Measured via the 2-item Maslach Burnout Inventory (MBI) The MBI is a 22-item survey that covers 3 areas: Emotional Exhaustion (EE), Depersonalization (DP), and low sense of Personal Accomplishment (PA). Each subscale includes multiple questions with frequency rating choices of Never, A few times a year or less, Once a month or less, A few times a month, Once a week, A few times a week, or Every day. The use of 2 single items from the MBI may also be used. Item 8 ("I feel burned out from my work",) and item 10 ("I have become more callous toward people since I took this job") correlate strongly with the emotional exhaustion and depersonalization subscale scores and concurrent validity has been demonstrated (J Gen Intern Med 2012;27:1445-52. J Gen Inter Med 2009;24:1318-21.) Individuals meet burnout criteria if they have high scores on either the EE (total score of 27 or higher) or DP (total score of 10 or higher) subscales.	0 and 3 months
Change from Baseline Burnout at 6 months	Measured via the 2-item Maslach Burnout Inventory (MBI) The MBI is a 22-item survey that covers 3 areas: Emotional Exhaustion (EE), Depersonalization (DP), and low sense of Personal Accomplishment (PA). Each subscale includes multiple questions with frequency rating choices of Never, A few times a year or less, Once a month or less, A few times a month, Once a week, A few times a week, or Every day. The use of 2 single items from the MBI may also be used. Item 8 ("I feel burned out from my work",) and item 10 ("I have become more callous toward people since I took this job") correlate strongly with the emotional exhaustion and depersonalization subscale scores and concurrent validity has been demonstrated (J Gen Intern Med 2012;27:1445-52. J Gen Inter Med 2009;24:1318-21.) Individuals meet burnout criteria if they have high scores on either the EE (total score of 27 or higher) or DP (total score of 10 or higher) subscales.	0 and 6 months
Change in Burnout from 3 to 6 months	Measured via the 2-item Maslach Burnout Inventory (MBI) The MBI is a 22-item survey that covers 3 areas: Emotional Exhaustion (EE), Depersonalization (DP), and low sense of Personal Accomplishment (PA). Each subscale includes multiple questions with frequency rating choices of Never, A few times a year or less, Once a month or less, A few times a month, Once a week, A few times a week, or Every day. The use of 2 single items from the MBI may also be used. Item 8 ("I feel burned out from my work",) and item 10 ("I have become more callous toward people since I took this job") correlate strongly with the emotional exhaustion and depersonalization subscale scores and concurrent validity has been demonstrated (J Gen Intern Med 2012;27:1445-52. J Gen Inter Med 2009;24:1318-21.) Individuals meet burnout criteria if they have high scores on either the EE (total score of 27 or higher) or DP (total score of 10 or higher) subscales.	3 and 6 months
Change from Baseline Sense of Community at 3 months	Measured via the Stanford Professional Fulfillment Index The Stanford Professional Fulfillment Index (PFI) is a 16-item survey that covers burnout (work exhaustion and interpersonal disengagement) and professional fulfillment. Response options are on a five-point Likert scale ("not at all true" to "completely true" for professional fulfillment items and "not at all" to "extremely" for work exhaustion and interpersonal disengagement items.) Items are scored 0 to 4. Each dimension is treated as a continuous variable. Scale scores are calculated by averaging the item scores of all the items within the corresponding scale. Scale scores can then be multiplied by 25 to create a scale range from 0 to 100. Higher score on the professional fulfillment scale is more favorable while higher scores on the work exhaustion or interpersonal disengagement scales are less favorable.	0 and 3 months
Change from Baseline Sense of Community at 6 months	Measured via the Stanford Professional Fulfillment Index The Stanford Professional Fulfillment Index (PFI) is a 16-item survey that covers burnout (work exhaustion and interpersonal disengagement) and professional fulfillment. Response options are on a five-point Likert scale ("not at all true" to "completely true" for professional fulfillment items and "not at all" to "extremely" for work exhaustion and interpersonal disengagement items.) Items are scored 0 to 4. Each dimension is treated as a continuous variable. Scale scores are calculated by averaging the item scores of all the items within the corresponding scale. Scale scores can then be multiplied by 25 to create a scale range from 0 to 100. Higher score on the professional fulfillment scale is more favorable while higher scores on the work exhaustion or interpersonal disengagement scales are less favorable.	0 and 6 months
Change in Sense of Community from 3 to 6 months	Measured via the Stanford Professional Fulfillment Index The Stanford Professional Fulfillment Index (PFI) is a 16-item survey that covers burnout (work exhaustion and interpersonal disengagement) and professional fulfillment. Response options are on a five-point Likert scale ("not at all true" to "completely true" for professional fulfillment items and "not at all" to "extremely" for work exhaustion and interpersonal disengagement items.) Items are scored 0 to 4. Each dimension is treated as a continuous variable. Scale scores are calculated by averaging the item scores of all the items within the corresponding scale. Scale scores can then be multiplied by 25 to create a scale range from 0 to 100. Higher score on the professional fulfillment scale is more favorable while higher scores on the work exhaustion or interpersonal disengagement scales are less favorable.	3 and 6 months
Change from Baseline Mentorship Connections at 3 months	Measured via unvalidated survey "How many meaningful relationships would you say you have with [medical students, residents/fellows, attendings]? A meaningful relationship could include any of the following: a) someone you'd get coffee/meal with, b) someone you'd be comfortable talking about career/life advice, c) someone you would be comfortable catching up with, etc."	0 and 3 months
Change from Baseline Mentorship Connections at 6 months	Measured via unvalidated survey "How many meaningful relationships would you say you have with [medical students, residents/fellows, attendings]? A meaningful relationship could include any of the following: a) someone you'd get coffee/meal with, b) someone you'd be comfortable talking about career/life advice, c) someone you would be comfortable catching up with, etc."	0 and 6 months
Change in Mentorship Connections from 3 to 6 months	Measured via unvalidated survey "How many meaningful relationships would you say you have with [medical students, residents/fellows, attendings]? A meaningful relationship could include any of the following: a) someone you'd get coffee/meal with, b) someone you'd be comfortable talking about career/life advice, c) someone you would be comfortable catching up with, etc."	3 and 6 months
Change from Baseline Burnout (Mayo) at 3 months	Measured via the Mayo Wellbeing Index The Mayo Wellbeing Index aims to identify distress in a variety of dimensions (burnout, fatigue, low mental/physical quality of life, depression, anxiety/stress). It has separate medical student, resident/fellow, and physicians versions and is a 7-item instrument with yes/no response categories. A total score is calculated by adding the number of 'yes' responses. In a sample of physicians, medical students, and US workers, every one point increase in score resulted in a step-wise increased probability of distress and risk for adverse personal and professional consequence. Score range is 0 to 7, and threshold score to identify individuals in distress is 4 or higher for medical students, 5 or higher for residents, 4 or higher for practicing physicians, and 2 or higher for other US workers.	0 and 3 months
Change from Baseline Burnout (Mayo) at 6 months	Measured via the Mayo Wellbeing Index The Mayo Wellbeing Index aims to identify distress in a variety of dimensions (burnout, fatigue, low mental/physical quality of life, depression, anxiety/stress). It has separate medical student, resident/fellow, and physicians versions and is a 7-item instrument with yes/no response categories. A total score is calculated by adding the number of 'yes' responses. In a sample of physicians, medical students, and US workers, every one point increase in score resulted in a step-wise increased probability of distress and risk for adverse personal and professional consequence. Score range is 0 to 7, and threshold score to identify individuals in distress is 4 or higher for medical students, 5 or higher for residents, 4 or higher for practicing physicians, and 2 or higher for other US workers.	0 and 6 months
Change in Burnout (Mayo) from 3 to 6 months	Measured via the Mayo Wellbeing Index The Mayo Wellbeing Index aims to identify distress in a variety of dimensions (burnout, fatigue, low mental/physical quality of life, depression, anxiety/stress). It has separate medical student, resident/fellow, and physicians versions and is a 7-item instrument with yes/no response categories. A total score is calculated by adding the number of 'yes' responses. In a sample of physicians, medical students, and US workers, every one point increase in score resulted in a step-wise increased probability of distress and risk for adverse personal and professional consequence. Score range is 0 to 7, and threshold score to identify individuals in distress is 4 or higher for medical students, 5 or higher for residents, 4 or higher for practicing physicians, and 2 or higher for other US workers.	3 and 6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Engagement in First Half of Study	Registration of >0 Metabolic Equivalent of a Task (MET) minutes on FitRankings platform	3 months
Engagement in Second Half of Study	Registration of >0 Metabolic Equivalent of a Task (MET) minutes on FitRankings platform	6 months
Change in Baseline Exercise at 3 months	On average, how many days per week do you exercise for 30 minutes or more? (0-7 days)	0 and 3 months
Change in Baseline Exercise at 6 months	On average, how many days per week do you exercise for 30 minutes or more? (0-7 days)	0 and 6 months
Change in Exercise from 3 to 6 months	On average, how many days per week do you exercise for 30 minutes or more? (0-7 days)	3 and 6 months
Change in Baseline Comfortability at work at 3 months	How comfortable do you feel about working with [medical students, residents/fellows, attending physicians] at your affiliated hospital? (1=not at all, 2=slightly, 3=moderately, 4=very, 5=extremely)	0 and 3 months
Change in Baseline Comfortability at work at 6 months	How comfortable do you feel about working with [medical students, residents/fellows, attending physicians] at your affiliated hospital? (1=not at all, 2=slightly, 3=moderately, 4=very, 5=extremely)	0 and 6 months
Change in Comfortability at work from 3 to 6 months	How comfortable do you feel about working with [medical students, residents/fellows, attending physicians] at your affiliated hospital? (1=not at all, 2=slightly, 3=moderately, 4=very, 5=extremely)	3 and 6 months

Collaborators and Investigators

• Sponsor: Harvard Medical School (HMS and HSDM)
• Collaborators: Massachusetts General Hospital
• Investigators: Study Director: Logan Briggs, BA, Harvard Medical School (HMS and HSDM)

Publications and helpful links

Helpful Links

• Medicine in Motion Trial Website

Study record dates

Study Major Dates

• Study Start (Actual): July 18, 2021
• Primary Completion (Estimated): May 31, 2024
• Study Completion (Estimated): July 31, 2024

Study Registration Dates

• First Submitted: December 30, 2021
• First Submitted That Met QC Criteria: January 14, 2022
• First Posted (Actual): January 18, 2022

Study Record Updates

• Last Update Posted (Actual): November 13, 2023
• Last Update Submitted That Met QC Criteria: November 9, 2023
• Last Verified: November 1, 2023

More Information

Terms related to this study

• Keywords: Exercise; Burnout, Professional; Mentorship; Burnout, Student; Community Building
• Additional Relevant MeSH Terms: Behavioral Symptoms; Stress, Psychological; Occupational Diseases; Burnout, Professional; Burnout, Psychological; Occupational Stress
• Other Study ID Numbers: 2021P000825

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No