Characterization of Medical Student Burnout Using Remote Physiologic Monitoring

A reliable method for monitoring stress and burnout among medical students is critically needed. To address this gap, our team aims to utilize the cost-effective WHOOP strap 4.0 wearable device to continuously capture stress-relevant physiologic data (i.e., sleep hours, heart rate variability, respiration rate, resting heart rate) among up to 50 third-year medical students at 24 Sidney Kimmel Medical College at Thomas Jefferson University for 6 months.

Study Overview

• Status: Enrolling by invitation
• Conditions: Burnout; Wellness; Remote Monitoring
• Intervention / Treatment: Device: WHOOP strap 4.0 (full data access); Device: WHOOP strap 4.0 (partial data access)

Detailed Description

Aim 1: To determine whether physiologic metrics of sleep and heart rate variability correlate with subjective assessments of medical student wellness in a 6-month period.

Hypothesis: Less total sleep hours will correlate with higher scores for Perceived Stress Scale-4, Medical Student Well-Being Index, and Patient Health Questionnaire-9, but lower heart rate variability will correlate with higher scores on Perceived Stress Scale-4, Medical Student Well Being Index, and Patient Health Questionnaire-9.

Aim 2: To determine whether physiologic metrics of sleep and heart rate variability correlate with performance on shelf examinations for clinical rotations in a 6-month period.

Hypothesis: Less total sleep hours and lower heart rate variability will correlate with poorer performance on shelf examinations.

• Study Type: Interventional
• Enrollment (Anticipated): 50
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Pennsylvania
    • Philadelphia, Pennsylvania, United States, 19107
      • Sidney Kimmel Medical College at Thomas Jefferson University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 99 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Third-year medical student at Thomas Jefferson University
• ≥18 years of age
• Actively participating in family medicine, internal medicine, neurology, obstetrics/gynecology, pediatrics, psychiatry, surgery, or emergency medicine rotations
• Own a smart phone for Bluetooth pairing with WHOOP strap 4.0

Exclusion Criteria:

• Allergies, contraindications, or unwillingness to wear a wrist device for the study period

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Diagnostic
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Treatment group; Subjects will have full remote monitoring data access throughout the entirety of the study (6 months).	Device: WHOOP strap 4.0 (full data access); The WHOOP strap 4.0 provides continuous physiologic data via remote monitoring. Subjects will have full remote monitoring data access throughout the entirety of the study (6 months).
Active Comparator: Control group; Subjects will be blinded to remote monitoring data for the first 3 months of the study followed by an unblinding and full access to remote monitoring data at the 3 month mark (continued for the remainder of the study).	Device: WHOOP strap 4.0 (partial data access); The WHOOP strap 4.0 provides continuous physiologic data via remote monitoring. Subjects will be blinded to remote monitoring data for the first 3 months of the study followed by an unblinding and full access to remote monitoring data at the 3 month mark (continued for the remainder of the study).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Total sleep hours per night	Sleep (hours per night) will be objectively measured nightly.	180 days
Medical Student Well-Being Index (MSWBI)	The MSWBI consists of 7 items, scored 0-7, with lower scores indicative of better medical student wellbeing. This survey will be administered biweekly.	180 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
REM sleep hours, nightly	REM sleep hours will be measured nightly by the WHOOP strap 4.0.	180 days
Deep sleep hours, nightly	Deep sleep hours will be measured nightly by the WHOOP strap 4.0.	180 days
Resting heart rate, nightly	Resting heart rate will be measured nightly by the WHOOP strap 4.0.	180 days
Heart rate variability, nightly	Heart rate variability will be measured nightly by the WHOOP strap 4.0.	180 days
Respiration rate, nightly	Respiration rate will be measured nightly by the WHOOP strap 4.0.	180 days
Pulse oximetry, nightly	Pulse oximetry will be measured nightly by the WHOOP strap 4.0.	180 days
Body temperature, nightly	Body temperature will be measured nightly by the WHOOP strap 4.0.	180 days
Average duty hours per week	Duty hours will be self-reported every week	180 days
Perceived Stress Scale-4	The PSS-4 consists of 4 items that assess perceived stress. The items are scored on a 4-point scale. This survey will be administered biweekly.	180 days
Patient Health Questionnaire-9 (PHQ-9)	The (Patient Health Questionnaire-9) PHQ-9 consists of 9 items that assess major depressive disorder. This survey will be administered biweekly. It is scored on a 0-27 scale with 27 representing most severe depression (worse outcomes).	180 days
Scores on shelf examinations	Subjects will self-report examination scores for shelf exams administered after each clinical rotation. Scores are reported on a 0-100 scale with 100 being the best score possible.	180 days

Collaborators and Investigators

• Sponsor: Thomas Jefferson University
• Investigators: Principal Investigator: Alexander Hajduczok, MD, Thomas Jefferson University Hospital, Department of Cardiology

Study record dates

Study Major Dates

• Study Start (Actual): August 22, 2022
• Primary Completion (Anticipated): February 22, 2023
• Study Completion (Anticipated): April 1, 2023

Study Registration Dates

• First Submitted: August 18, 2022
• First Submitted That Met QC Criteria: August 18, 2022
• First Posted (Actual): August 22, 2022

Study Record Updates

• Last Update Posted (Actual): August 24, 2022
• Last Update Submitted That Met QC Criteria: August 23, 2022
• Last Verified: August 1, 2022

More Information

Terms related to this study

• Keywords: WHOOP strap 4.0
• Additional Relevant MeSH Terms: Behavioral Symptoms; Stress, Psychological; Burnout, Psychological
• Other Study ID Numbers: 21D.754

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: Yes